ANATOMICAL  DESCRIPTION 


or 


THE  ARTERIES 

or  THE 

HUMAN  BODY, 


ILLUSTRATED 

BY  SEVERAL  COLOURED  ENGRAVINGS,  SELECTED  AND 
REDUCED  FROM  THE  ICONES  OF  HALLER, 


EXHIBITING  THE  PARTS 

AS  THEY  APPEAR  ON  DISSECTION. 


TROM  THE  LAST  LONDON  EDITION. 

Corrected  and  Improved. 


BOSTON  : 

PRINTED  BY  THOMAS  B.  WAIT  AND  CO.  FOR  THE  PROPRIETOR. 


1813, 


Digitized  by  the  Internet  Archive 
in  2016 


https://archive.org/details/anatomicaldescri01hall 


ADVERTISEMENT. 


Having,  been  requested  to  examine  this  description  of  the 
arteries,  and  also  a copy  of  one  of  the  engravings,  executed  on 
wood;  I undertook  this  task  without  hesitation,  because  a pub- 
lication on  this  part  of  anatomy  seemed  very  desirable  here. 
On  comparing  the  engravings  in  the  Euglish  edition  with  the 
originals  in  the  invaluable  work  of  Haller,  they  were  found 
to  be  as  faithful  and  satisfactory  imitations,  as  could  be  exe- 
cuted on  a small  scale,  and  also  to  be  better  calculated  than 
any  similar,  to  assist  in  obtaining  a knowledge  of  the  situ- 
ation of  all  the  important  arteries.  An  impression  from 
the  engraving  on  wood  was  compared  with  the  copper-plate 
impression  of  the  London  edition  ; and  appeared  to  me,  though 
inferior  in  beauty,  yet  fully  equal  in  utility.  Some  of  the 
impressions  from  the  engravings  done  in  this  country,  seem 
to  convey  even  more  distinct  notions  of  the  parts  they  repre- 
sent, than  those  of  the  English  work.  Being  thus  satisfied, 
that  the  work  proposed  would  be  a very  valuable  acquisition 
to  surgical  practitioners,  at  an  easy  rate,  I agreed  to  afford 
every  assistance  in  the  prosecution  of  it,  which  circumstances 
would  admit. 

The  references  to  the  plates  in  the  London  edition,  are 
made  with  singular  negligence.  The  arteries  alone  being  de- 
signated, while  the  parts,  they  are  connected  with,  are  wholly 
neglected.  As  a knowledge  of  the  existence  of  these  vessels, 


iv 


ADVERTISEMENT. 


without  that  of  the  parts  to  which  they  are  related,  would  be  of 
little  practical  use,  the  first  object  attended  to  was  the  arrang- 
ing these  references  anew.  This  was  done  by  comparing  them 
with  the  great  work  of  Haller. 

The  English  text  is  printed  from  a work  of  established 
merit ; but  with  so  little  attention  that  errors  in  letters  are 
exactly  reprinted.  The  text  is  defective  also,  in  common 
with  most  of  our  descriptions  of  the  arteries,  in  passing  rather 
slightly  over  most  of  the  great  arteries  : while  a very  great 
number  of  small  branches  are  enumerated.  Every  one  becomes 
sensible  in  practice  that  an  acquaintance  with  these  minute 
branches  is  absolutely  useless  ; and  that  on  the  other  hand,  there 
is  no  description  of  the  large  vessels  that  is  minute  enough  to 
enable  him  to  avoid  or  to  search  for  a great  artery  with  calm- 
ness and  confidence.  It  was  proposed  to  remedy  this  defect, 
as  far  as  it  can  be  remedied  in  descriptions,  by  collecting  from 
the  works  of  Haller,  Soemmering,  Boyer  and  Bichat,  the  most 
particular  and  satisfactory  accounts  of  the  relations  of  these 
arteries  to  the  parts  near  which  they  are  situated.  This  has 
been  in  some  degree  effected  with  regard  to  the  aorta,  carotids, 
right  and  left  subclavians,  iliac,  inguinal  and  femoral  arteries  ^ 
but  after  this  had  been  done,  certain  circumstances  rendered  it 
necessary  for  the  proprietor  of  the  work  to  complete  its  publi- 
cation in  the  course  of  a few  days.  For  this  reason  the  com- 
plete execution  of  the  plan  was  necessarily  interrupted  ; and 
also  my  inspection  of  the  newly  printed  sheets. 

The  general  description  of  the  arteries,  which  serves  as  an 
introduction,  was  prepared  for  the  American  edition — The 
division  of  these  vessels  is  adopted  from  Bichat. 

JOHN  C.  WARREN. 


Boston,  December  1,  1813. 


CONTENTS 


The  arteries  in  general  . , 9 

Structure  of  the  arteries  • . . 12 

General  view  of  the  distribution  of  the  arteries  . , 13 


aorta  . ... 

DIVISION  I. 

Arteries  from  the  origin  of  the  aorta. 
Right  Coronary 

Left  Coronary  . , 

DIVISION  II. 

Arteries  from  the  curvature  of  the  aorta 

Common  Carotid  Arteries 
External  Carotid 
Superior  Thyroid 
Lingual  Artery 
Ranina  . . 

Labial 

Ascending  Pharyngeal  Artery  of  Haller 

Occipital  Artery 

Posterior  Auricular 

Temporal  or  Superficial  Temporal 

Articular  Artery  of  the  Maxilla 

Transverse  Artery  of  the  Face 

Middle  Temporal  Branch 

Anterior  Auricular  Arteries 

Internal  Maxillary 

Deep  Auricular  Artery 

Artery  of  the  Tympanum 

Small  Meningeal  Artery 

Middle  Meningeal  Artery 

Inferior  Maxillary  Artery 

Deep  External  Temporal  Artery- 

Deep  Internal  Temporal  Artery 

Artery  of  the  Cheek 

Alveolar  Artery 

Infraorbital  Artery 

Pterygopalatine  Artery 

Nasal  Artery 

Internal  Carotid,  or  Cerebral  Artery 
Posterior  Artery  of  the  Receptacle  Sinus 


19 


21 

ib. 

22 


ib. 

23 

26 

27 
ib. 

28 
ib. 

30 

31 
ib. 

32 

33 
ib. 
ib. 
ib. 

34 
ib. 

35 
ib. 
ib. 
ib. 

36 
ib. 
ib. 
ib. 
ib. 
ib. 

37 
ib. 
39 


vi 


CONTENTS, 


Anterior  Artery  of  the  Receptacle 
Ophthalmic  Artery 
Central  Artery  of  the  Retina 
Long  Internal  Ciliary  Artery 
Inferior  Muscular  Artery 
Inferior  Ciliary  Artery 
Posterior  Ethmoidal  Artery 
Anterior  Ethmoidal  Artery 
Inferior  Palpebral  Artery 
Superior  Palpebral  Artery 
Nasal  Artery 
frontal  Artery 
Communicating  Artery 
Anterior  Carotid  Artery  . 

Posterior  Carotid,  or  Artery  of  the  Fossa  Sylviana 


39 
ib. 

40 
ib. 
ib. 

41 
ib. 
ib. 
ib. 
ib. 
ib. 
ib. 
ib. 

42 
ib. 


The  subclavian  artery  and  its  branches  . 43 

Superior  Intercostal  Artery  . , 48 

Vertebral  Artery  . . . ib. 

Inferior  Artery  of  the  Cerebellum  . . 49 

Posterior  Spinal  Artery  . . 50 

Anterior  Spinal  Artery  . # . ib. 

Basilar  Artery  . . . ib. 

Deep  Arteries  of  the  Cerebellum  . .51 

Deep  Artery  of  the  Cerebrum  : . ib. 

Inferior  Thyroid,  or  Anterior  Cervical  Artery  . ib. 

Ascending  Thyroid  Artery  . . 53 

Deep  or  Posterior  Cervical  . . 54 

Superficial  Cervical  . , .55 


Distribution  of  the  axillary  artery  . ib. 

Highest  Thoracic  Branch  ...  56 

Long  or  Superior  Thoracic,  or  External  Mammary  . ib. 

Humeral  Thoracic  . • . ib. 

Alar  Thoracic  . . 57 

Inferior  Scapular,  or  Infra  Scapular,  or  Subscapular  . ib. 

Scapular  Circumflex  ...  .58 

Posterior  Circumflex  Artery  . . ib. 

Anterior  Circumflex  Artery  . . '59 


Distribution  of  the  brachial  or  humeral  artery  ib. 
Deep  Branch  of  the  Humerus — the  large  Collateral  or  large  Hu- 
meral Profunda  . . . .60 

Large  communicating  Radial  . . 61 

Large  communicating  Ulnar  . . . ib. 

Large  nutritious  Artery  of  the  Humerus  . . 62 

Lesser  Profunda  . . . ib. 

Large  Anastomotic  . . . ib. 

Ulnar  Artery  . . . .63 

Highest  Interosseal  Perforant  . . 64 

Ulnar  Recurrent  . . . ib. 

Nutritious  Artery  of  the  Ulna  . 65 

Common  Interosseal  . ib 


CONTENTS 


Ml 


Dorsal  of  the  hand  . 

Dorso-Ulnar  of  the  little  Alger 

Ulnar  Profunda,  or  Deep  Ulnar  branch  of  the  hand 

Vola-Ulnar  of  the  little  finger 

First  Vola-Digital 

Second  Vola-Digital 

Third  Vola-Digital 

Radial  Artery 

Superficial  Volar 

Vola-Ulnar  of  the  thumb 

Dorso-Radial  of  the  thumb 

Dorso-Ulnar  of  the  thumb 

Dorso-Carpal 

Pollicar,  or  principal  Artery  of  the  thumb 
Superior  Volar  Perforants 
Inferior  Volar  Perforants 

DIVISION  III. 

Arteries  from  the  thoracic  aorta 
Superior  and  Posterior  Pericardiac  Artery 
Common  Bronchial  Artery 
Right  Bronchial  Artery 
CEsophagal  Arteries 

DIVISION  IV. 

Arteries  from  the  abdominal  aorta 

Phrenic  Artery 
C celiac  Artery 

Hepatic  . . ... 

Splenic 

Superior  Mesenteric 
Inferior  Mesenteric 
Capsular,  or  Atrabiliary 
Renal,  or  Emulgent-  Artery 
Spermatic  Artery 
Adipose  Arteries 
Ureteric  Arteries 
Lumbar  Arteries 

DIVISION  V. 

Arteries  'which  terminate  the  aorta 

The  primitive  iliacs 

Sacro-Median  Artery 

Internal  Iliac,  or  Hypogastric 

Ileo-Lumbar,  or  Small  Iliac 

Sacro-Lateral  Arteries 

Umbilical  Artery 

Inferior  Vesecal  Arteries 

Middle  Hemorrhoidal  Artery 

Uterine 


67 

ib. 

68 

ib. 

ib. 

69 

ib. 

70 

72 

ib. 

73 

ib. 

74 

ib. 

75 

ib. 

76 

ib. 

ib. 

77 

ib 

79 

80 

82 

83 

86 

87 

90 

92 

93 

94 

95 

96 

ib. 

98 

ib. 

99 

100 

101 

ib. 

102 

103 

104 

ib. 


Vlll 


CONTENTS 


Obturator  Artery 

Posterior  Iliac,  or  Gluteal  . . . 

Ischiadic  .... 

Common  Fudic — the  Pudic — Circumflex,  Internal,  Middle,  or  Ex- 
ternal Pudic 
Deep  Perineal 

Profunda,  or  deep  Branch  of  the  Penis 
External  Iliac 

Epigastric  ... 

Funicular  Artery 

Circumflex  Iliac,  Abdominal,  or  small  External  Iliac 

Femoral  Artery 

Superior  External  Pudic 

Middle  External  Pudic 

Inferior  External  Pudic 

Superior  Perforant 

Inferior  Perforant 

Profunda,  or  Deep  Femoral  Artery 

External  Circumflex 

Internal  Circumflex  ... 

First  Perforant 
Second  Perforant 
Popliteal  Artery 
Superior  Externo-Articular 
Superior  Interno-Articular 
Middle  Articular 
Inferior  Externo-Articular 
Inferior  Interno-Articular 
Muscular  Branches 
Anterior  Tibial  Artery 
Tibial  Recurrent 
Internal  Malleolar 
External  Malleolar 
Transverse  Tarsal 
Transverse  Metatarsal  Artery 

Dorso-Metatarsal,  or  External  Dorsal  of  the  great  toe  . 

Posterior  Tibial  Artery 

Large  nutritious  Artery  of  the  Tibia 

Common  Fibular 

Nutritious  Artery  of  the  Fibula 

Posterior  Fibular 

Anterior  Fibular 

External  Plantar 

Internal  Plantar 


105 

103 

109 

110 

113 

ib. 

114 

117 

ib. 

118 

119 

122 

ib. 

ib. 

124 

125 

126 

12  7 

129 

130 

132 

134 

135 

ib. 

136 

137 

ib. 

138 

139 

140 

141 

ib. 

142 

144 

145 

ib. 

146 

147 

148 

ib. 

149 

150 

155 


ARTERIES  IN  GENERAL. 


The  arteries  are  vessels  which  receive  blood 
from  the  heart  and  distribute  it  to  all  parts  of  the 
body.  They  were  formerly  described  as  being 
of  a conical  form  ; but  this  description  is  not  cor- 
rect, for  on  a careful  examination  it  appears  that 
an  artery  does  not  diminish  in  size  between  one 
branch  and  the  next  below,  but  preserves  a cyl- 
indrical form  during  that  space.  The  arteries 
may  therefore  be  considered  as  chains  of  cylin- 
ders, of  sizes  gradually  lessening,  and  connected 
together. 

As  the  arteries  are  constantly  sending  off 
branches  in  their  course  from  the  heart,  and 
these  send  off  others  of  smaller  size,  it  is  ne- 
cessary to  employ  different  terms  to  express 
the  different  sizes  of  these  vessels.  The  two 
largest  arteries,  the  aorta  and  pulmonary  artery,  . 

1 


10 


from  which  all  the  others  spring,  are  called  the 
great  trunks.  These  send  off  other  large  ves- 
sels which  are  branches,  and  the  branches  send 
off  other  smaller  branches  or  ramusculi.  We 
usually,  however,  apply  the  term  of  large  artery 
to  vessels  of  the  second  order ; while  those  of  the 
third,  are  denominated  branches,  and  those  sent 
off  by  them  are  ramusculi.  As  for  example,  the 
carotid  artery  sends  out  its  facial,  lingual,  and 
temporal  branches,  and  each  of  these  gives  many 
ramusculi. 

At  those  places  where  branches,  &c.  are  given 
off,  there  is  a peculiar  arrangement  for  favouring 
the  entrance  of  blood  into  the  collateral  vessel. 
At  the  opening  of  the  latter  are  observed  two 
edges,  or  semicircular  arches,  one  of  which  is 
near  the  heart  and  the  other  distant  from  it.  The 
first  is  continuous  with  the  principal  vessel,  while 
the  latter  is  very  sharp  and  prominent,  extending 
apparently  into  the  canal  of  the  vessel  in  order  to 
oppose  the  passage  of  blood  through  it,  and  to 
give  a part  of  the  fluid  a lateral  direction. 

The  arteries  terminate  principally  in  minute 
vessels  called  capillaries ; these  are  found  in  infi- 
nite numbers  in  every  organized  part  of  the  body 
and  constitute  a considerable  portion  of  each  or- 
gan. Into  these  little  vessels,  the  arteries  carry 
their  blood,  which  having  circulated  in  them  and 
undergone  a remarkable  change,  is  transmitted  to 


II 


the  veins.  The  anatomists  of  the  present  day,  do 
not  indeed  seem  to  be  decided,  whether  to  con- 
sider the  capillary  vessels  as  a system  separate 
from  that  of  the  arteries.  But  as  these  capillaries 
seem  to  be  governed  by  laws  in  some  degree  dis- 
tinct from  those  which  regulate  the  arteries,  we 
think  it  best  to  treat  them  as  forming  a distinct 
system.  Then  the  first  and  principal  termination 
of  the  arteries  is  in  the  capillary  vessels.  Another 
termination  of  the  arteries  is  by  anastomosis, 
which  is  the  opening  of  one  artery  into  another. 
This  anastomosis,  or  communication  of  arteries 
with  each  other,  is  common  in  every  part  of  the 
body,  and  most  so,  in  those  parts  which  are  most 
exposed  to  pressure.  It  is  of  great  importance 
in  the  animal  economy,  because  it  allows  the  cir- 
culation of  the  blood  to  be  carried  on  by  the 
communicating  branches,  when  the  principal  ones 
are  obstructed.  Thus  when  the  femoral  artery 
is  tied,  the  life  of  the  limb  below  the  ligature  is 
supported  by  means  of  branches  from  the  upper 
part  of  the  thigh  anastomosing  with  those  near  the 
knee.  Arteries  terminate  also  in  cells ; such  as 
those  which  constitute  the  spongy  substance  of 
the  penis.  Into  these  the  arteries  pour  their  blood, 
which  is  carried  thence  by  the  veins.  Lastly, 
arteries  terminate  in  glands,  that  is,  in  the  secre- 
tory parts  of  those  organs  ; the  parts  which  per- 


12 


form  a peculiar  process  on  the  blood,  and  produce 
from  it  some  new  substance,  such  as  the  bile, 
urine,  and  saliva. 

STRUCTURE  OF  ARTERIES. 

The  arteries  have  three  coats,  besides  a loose 
coat  of  cellular  membrane  called  the  sheath  of  the 
artery.  This  sheath  is  composed  of  layers  of 
cellular  membrane  more  or  less  condensed.  The 
artery  lies  loosely  in  this  sheath,  so  as  to  be  ca- 
pable of  being  drawn  backward  and  forward  a 
little  way  ; for  it  is  connected  with  this  sheath  by 
a yielding  cellular  membrane.  The  three  proper 
coats  of  the  artery  have  been  called  cellular,  mus- 
cular and  cuticular. — It  is  best,  however,  to  de- 
nominate them  external,  middle  and  internal  coats. 
The  external  coat  is  composed  of  many  thin  lay- 
ers of  membrane  closely  connected  together,  but 
capable  of  being  separated  by  the  knife  and  by 
putrefaction.  It  is  the  strongest  of  the  three 
coats  ; so  that  a ligature  applied  over  it  ruptures 
the  middle  and  internal  coats,  while  the  external 
remains  entire.  The  second  coat  is  composed 
of  many  layers  of  circular  fibres,  none  of  which 
form  a complete  circle.  These  fibres  are  of  a 
yellowish  colour.  They  are  united  to  each  other 
by  dense  membrane.  This  coat  is  strong  in  a 
circular  direction,  but  weak  longitudinally.  W hen 
therefore  the  cuter  coat  is  removed,  the  artery 


IS 


may  easily  be  tom  if  pulled  in  the  direction  of 
its  length ; but  not  in  the  direction  of  its  breadth. 
This  coat  is  considered  by  some  anatomists  to  be 
peculiar  to  the  arteries,  and  different  from  any 
other  structure  in  the  body.  The  internal  coat 
is  thin  ; of  a reddish  colour ; extremely  fragile. 
Its  external  surface  is  united  to  the  middle  coat 
by  a thin  layer  of  common  membrane.  Its  inter- 
nal face  is  smooth ; shining,  being  moistened 
with  an  unctuous  substance,  which  serves  to  fa- 
cilitate the  passage  of  blood  through  the  vessel. 
Its  texture  is  very  close,  to  retain  the  blood  in  its 
canals  more  perfectly. 

The  coats  of  the  arteries  have  small  arteries 
and  veins,  except  the  internal  coat,  which  does 
not  exhibit  them.  No  nerves  can  be  traced  run- 
ning into  them,  although  many  are  seen  on  their 
outer  coat. 

GENERAL  VIEW  OE  THE  DISTRIBUTION  OE  THE 
ARTERIES. 

The  arteries  all  originate  from  two  great  trunks, 
the  pulmonary  artery  which  goes  to  the  lungs 
and  is  described  with  that  organ,  and  the  aorta 
which  supplies  the  rest  of  the  body.  The  aorta 
arises  from  the  left  ventricle  of  the  heart,  and  at 
its  origin  supplies  that  organ  with  two  small  arte- 
ries called  coronary  or  cardiac.  There  the  aorta 
rises  and  forms  an  arch,  from  which  are  sent  off 


14 


three  great  arteries.  On  the  right  side  a vessel 
called  arteria  innominata,  which  after  running  an 
inch  is  divided  into  the  right  subclavian  and 
right  carotid  arteries.  On  the  left  are  sent  off 
the  left  carotid  and  left  subclavian  arteries.  The 
subclavian  artery  goes  out  of  the  chest  to  the  lower 
part  oi  the  neck,  where  it  gives  seven  cr  eight 
principal  branches  to  the  neck,  breast  and  shoul- 
der, it  comes  down  under  the  clavicle  and  takes 
the  name  of  axillary  artery.  From  the  axillary 
are  sent  six  or  seven  considerable  vessels  to  the 
outer  part  of  the  thorax  and  the  shoulder.  Hav- 
ing crossed  the  axilla  or  armpit  to  the  upper  part 
of  the  arm,  the  artery  is  then  called  brachial.  It 
runs  along  the  inside  of  the  arm,  giving  one  princi- 
pal and  many  smaller  branches  to  the  muscles  of 
the  arm  and  to  the  elbow ; below  which  it  divides 
into  two  vessels,  called  radial  and  ulnar  arteries. 
The  former  takes  its  course  near  the  outer  edge 
of  the  arm,  becomes  very  superficial  at  the  wrist, 
sends  an  artery  on  the  back  of  the  thumb,  and 
passes  itself  to  the  palm  of  the  hand,  where  it 
terminates  in  the  superficial  palmer  arch ; from 
which  are  sent  arteries  to  the  thumb  and  fingers 
near  it.  The  ulnar  artery  at  its  beginning  sends 
down  two  considerable  branches,  one  along  the 
middle  of  the  arm  on  its  fore  part,  another  along 
the  middle  of  the  arm  on  its  back  part,  both  of 
which  ultimately  get  to  the  back  of  the  hand, 


15 


where  a sort  of  arch  is  formed.  The  ulnar  artery 
runs  near  the  inside  of  the  arm  to  the  wrist,  gives 
many  branches  to  the  muscles  of  the  fore-arm, 
passes  on  the  palm  of  the  hand  and  forms  the  deep 
palmar  arch,  which  gives  arteries  to  the  inner 
fingers ; each  finger  receiving  two  arteries. 

The  carotid  artery,  arising  from  the  aorta  on 
the  left,  and  from  the  arteria  innominata  on  the 
right  side,  goes  out  at  the  upper  part  of  the  tho- 
rax near  the  trachea.  It  is  seen  at  the  lowest 
part  of  the  neck  very  near  the  side  of  the  trachea, 
and  then  ascending  the  neck  it  gradually  quits 
the  trachea,  running  a little  outward  toward  the 
angle  of  the  lower  jaw.  In  this  course  it  sends 
out  no  branches ; but  when  come  near  to  the 
angle  of  the  jaw,  it  divides  into  two  arteries  call- 
ed external  and  internal  carotid  arteries.  The 
external  carotid  artery  is  no  sooner  formed,  than 
it  is  divided  into  about  eight  branches,  which 
supply  blood  to  the  upper  part  of  the  neck,  the 
face,  mouth,  tongue,  throat,  and  all  the  external 
parts  of  the  head.  The  internal  carotid  is  larger 
than  the  other,  it  runs  backward  and  upward  to 
the  inferior  part  of  the  skull,  passes  by  a circuit- 
ous course  through  the  carotid  canal  to  the  base 
of  the  brain,  and  is  wholly  distributed  to  this  or- 
gan, except  a branch  sent  into  the  orbit  of  the 
eye  from  behind. 


16 


After  the  aorta  has  formed  its  arch  and  given 
the  great  arteries  to  the  head  and  arms,  it  descends, 
runs  from  left  to  right,  to  get  near  the  spine,  along 
which  it  passes  through  the  thorax,  distinguish- 
ed by  the  name  of  thoracic  aorta.  In  this  course 
small  arteries  are  given  to  the  bronchiae,  pericar- 
dium, oesophagus,  and  mediastinum,  and  ten  or 
twelve  branches  run  along  the  ribs  and  are  dis- 
tributed to  the  muscles  of  the  back,  breast,  and 
to  the  intercortal  muscles.  The  aorta,  passing 
through  the  diaphragm,  quits  the  thorax,  enters 
the  cavity  of  the  abdomen,  and  is  then  called  ab- 
dominal aorta.  It  gives  arteries  to  the  diaphragm, 
renal  capsules,  kidneys,  testis,  muscles  of  the  back 
and  abdomen ; and  from  its  fore  part  sends  three 
large,  unpaired  vessels,  the  cceliac,  superior  and 
inferior  mesenteric,  to  supply  all  the  viscera  of  the 
abdomen.  At  the  third  lumbar  vertebra  it  divides 
into  two  vessels,  one  of  which  goes  to  the  right 
the  other  to  the  left.  This  division  is  called  the 
bifurcation  of  the  aorta,  and  the  arteries  which 
are  produced  by  it,  are  the  common  iliac  arteries. 
As  the  common  iliac  passes  near  the  brim  of  the 
pelvis  it  is  divided  into  external  and  internal  iliac 
arteries.  The  latter  which  is  sometimes  called 
the  hypogastric,  descends  into  the  pelvis,  and 
first  gives  four  or  five  vessels  to  the  organs  con- 
tained in  that  cavity  and  is  afterwards  expended 
in  four  large  branches,  which  terminate  out  of  the 


17 


pelvis,  in  the  muscles  of  the  thigh  and  external 
organs  of  generation. 

The  external  iliac  artery,  soon  after  quitting  the 
internal,  leaves  the  abdominal  cavity,  giving  at 
the  place  of  its  exit  a branch  to  the  muscles  within 
the  upper  part  of  the  pelvis  and  a remarkable 
branch  called  epigastric,  which  ascends  the  abdo- 
men on  the  inside  of  the  muscles  that  cover  the 
fore  part  of  that  cavity.  No  sooner  does  the 
external  iliac  appear  at  the  upper  part  of  the  thigh, 
than  it  is  called  the  femoral  artery.  This  vessel 
gives  superficial  branches  to  the  skin  of  the  ex- 
ternal parts  of  generation,  and  to  the  upper  part 
of  the  thigh  : when  it  has  passed  a very  little  way 
down  the  thigh,  a large  vessel  almost  equal  to  the 
femoral  in  size  is  sent  downward,  inward  and 
backward  among  the  deep  muscles  of  the  thigh, 
which  it  supplies  with  blood  quite  to  the  ham. 
The  femoral  artery  itself  goes  down  the  inside  of 
the  thigh  getting  gradually  deeper  and  supplying 
branches  to  the  muscles,  without  being  greatly 
diminished  in  size.  Some  distance  above  the 
knee  it  perforates  the  muscle  triceps  and  turns  to 
the  back  part  of  the  thigh,  where  it  receives  the 
name  of  popliteal  artery.  The  knee  obtains  its 
vessels,  five  or  six  in  number,  from  this  artery. 
At  the  head  of  the  tibia  the  artery  divides  into 
two,  which  are  the  anterior  and  posterior  tibial 
arteries.  The  anterior  tibial  passes  from  the  back 
2 


18 


part  to  the  fore  part  of  the  leg*,  goes  down  between 
the  two  bones  to  the  upper  part  of  the  foot , where  it 
is  still  a considerable  vessel,  and  at  last  disappears 
near  the  root  of  the  great  toe,  where  it  forms  an 
important  communication  through  the  foot  with 
the  arteries  on  the  inferior  part.  The  posterior 
tibial,  first  sends  a branch  called  the  peroneal  ar- 
tery to  the  fibula,  the  outer  bone  of  the  leg,  along 
which  it  descends  to  terminate  about  the  outer 
ankle.  The  posterior  tibial,  which  is  the  largest 
of  the  two  principal  arteries  of  the  leg,  runs  down 
behind  the  tibia  to  the  depression  behind  the  inner 
ankle,  supplying  the  muscles  as  it  passes.  From 
the  ankle  it  turns  under  the  foot  and  divides  into 
the  external  and  internal  plantar  arteries.  The 
first  of  these  makes  a circuit  round  the  outer  edge 
of  the  foot  and  near  the  roots  of  the  toes  turns  to 
cross  the  foot  in  an  arched  form  and  meets  with 
the  artery  it  had  before  quitted,  the  internal  plan- 
tar. From  the  arch  formed  by  the  two,  the  toes 
are  supplied,  each  with  two  arteries.  The  inter- 
nal plantar  seems  to  form  that  part  of  the  arch 
which  supplies  the  great  toe  and  the  inside  of  the 
second,  while  the  remainder  of  the  arch  appears 
to  be  a continuation  of  the  external  plantar  artery. 


19 


AORTA. 

The  aorta  commences  at  the  left  ventricle 
of  the  heart.  From  the  fleshy  substance  of  the 
parietes  of  this  ventricle  it  receives  its  origin, 
not  by  a continuation  of  the  substance  of  the 
ventricle  into  the  artery,  but  by  a substance 
wholly  different.  The  internal  coat  alone  of 
the  artery  is  actually  continuous  with  the 
membrane  which  lines  the  ventricle.  At  its 
orifice  are  placed  three  membraneous  pro- 
jections, resembling  the  semicircular  festoons 

of  a curtain,  which  are  the  semilunar  valves 

% 

of  the  aorta.  They  are  formed  from  the 
membrane  which  lines  the  aorta  and  the 
ventricle. 

At  its  origin  the  aorta  is  quite  concealed  by 
the  pulmonary  artery  placed  before  it ; but 
after  passing  half  an  inch  to  the  right,  it  is 
seen  on  the  right  side  of  the  latter,  along 
which  it  rises  curving  to  the  left.  In  this 
first  part  of  its  course  it  is  enclosed  in  the 


20 


pericardium.  The  pulmonary  artery  and  its 
right  branch  nearly  surround  it.  Then  it 
comes  to  the  middle  of  the  spine,  where  it  is 
placed  on  the  trachea,  a little  above  the 
bifurcation  of  the  bronchiae ; then  it  goes  on 
curving  to  the  left,  above  the  left  trunk  of  the 
pulmonary  artery.  This  is  called  the  curva- 
ture or  arch  of  the  aorta. 

When  the  aorta  has  reached  the  left  trunk 
of  the  pulmonary  artery,  it  enters  the  pleura 
between  that  membrane  and  the  spine;  changes 
its  direction  and  goes  perpendicularly  down- 
ward, through  the  posterior  mediastinum. 
In  this  course,  it  is  placed  on  the  bodies  of 
the  vertebrae,  but  a little  to  the  left  of  their 
middle  line,  while  the  oesophagus  is  on  the 
right  of  the  same  line  ; and  of  course  on  the 
right  side  of  the  aorta,  together  with  the  thora- 
cic duct  and  vena  zygos.  Before  it,  is  the  divi- 
sion of  the  bronclwse,  then  the  pleura,  where 
its  two  largest  unite  from  the  posterior  medi- 
astinum. On  the  left  side  it  is  in  contact 
with  the  left  pleura. 


21 


Quitting  the  thorax,  the  aorta  passes 
between  the  appendices  of  the  diaphragm  and 
enters  the  abdomen.  It  still  lies  on  the  ver- 
tebrae, along  which  it  descends  through  the 
abdomen  to  the  fourth  or  fifth  lumbar  verte- 
brae, where  it  is  divided  into  two  vessels,  the 
common  iliac  arteriest  In  its  abdominal 
course,  the  aorta  has  the  spine  behind  it,  the 
vena  cava  inferior  on  its  right  side,  the  peri- 
toneum before  it  and  on  its  left. 

In  examining  the  arteries,  which  spring  from 
the  aorta  the  following  divisions  are  necessary  to 
a methodical  arrangement. 

I.  Arteries  from  the  origin  of  the  aorta. 

II.  Arteries  from  the  curvature  of  the  aorta. 

III.  Arteries  from  the  thoracic  aorta. 

IV.  Arteries  from  the  abdominal  aorta. 

V.  Arteries  which  terminate  the  aorta. 

I.  ARTERIES  PROM  THE  ORIGIN  OF  THE 
AORTA. 

1.  The  Right  Coronary — is  larger  than  the 
left,  it  runs  between  the  auricle  and  ventricle  to 
the  flat  surface  and  apex  of  the  heart,  inosculating 
freely  with  the  left  coronary  both  by  its  branches 
and  the  extremity  of  its  trunk. 

These  branches  are, 

One  running  on  the  right  of  the  aorta,  and  on  the  left 

to  the  pulmonary  artery. 


22 


A number  going  to  both  sides  of  the  right  auricle— to 
the  two  venas  cavae— -to  the  aorta — and  to  the  pulmonary 
•veins. 

Branches  winding  on  the  convex  surface  of  the  heart  j 
the  longest  of  which  unites  with  the  left  coronary  branches 
beyond  the  septum,  near  the  apex. 

Branches  passing  over  the  plain  surface  and  right  ven- 
tricle, as  far  as  the  apex  of  the  heart. 

2.  The  Left  Coronary — after  going  out 
between  the  pulmonary  artery  and  the  left  auricle, 
divides  into  two  branches — 

An  anterior  branch,  running  upon  the  convex  surface  of 
the  heart,  towards  the  septum,  in  a winding  direction,  to 
the  apex,  where  it  is  reflected  on  the  posterior  surface  of 
the  heart. 

This  gives, 

A circumflex  Posterior  Branch,  which,  winding  between 
the  left  auricle  and  the  ventricle  to  the  rounded  extremity 
of  the  heart,  terminates  towards  the  apex,  upon  the  flat 
surface. 

II.  ARTERIES  FROM  THE  CURVATURE  OF 
THE  AORTA. 

The  curvature  of  the  aorta  gives  origin  to 
three  great  arteries  from  its  convex  side. 
1.  The  arteria  innominata,  which  immediately 
divides  into  the  right  carotid  and  right  sub- 
clavian. 2.  The  left  carotid.  3.  The  left 
subclavian. 

The  arteria  innominata  rises  from  the  aorta 
in  front  of  the  trachea,  runs  upward  and  out- 


23 


ward  on  the  side  of  that  tube  and  after  a 
passage  of  an  inch,  divides.  It  is  covered  by 
the  left  subclavian  vein,  by  the  sternum  and 
the  sterno-thyroid  muscle  ; behind,  it  corres- 
ponds with  the  trachea  and  the  longus  colli 
muscle,  which  separate  it  from  the  spine. 

The  left  carotid  is  nearly  on  a level  with 
the  innominata,  but  a little  farther  back.  It 
rises  at  right  angles  with  the  aorta,  and  ascends 
perpendicularly  on  the  side  of  the  trachea. 

The  left  subclavian  is  farthest  back  of  the 
three.  It  rises  from  the  aorta  just  before  this 
penetrates  between  the  two  pleurae. 

Thus  the  arteria  innominata  and  the  left 
carotid  embrace  the  trachea,  on  which  the  for- 
mer partly  lies.  The  right  carotid  and  subcla- 
vian are  shorter  than  the  left,  by  the  length  of 
the  arteria  innominata. 

COMMON  CAKOTID  AETEEIES. 

The  two  great  carotid  arteries,  originating 
in  the  manner  just  mentioned,  ascend  a little 
obliquely  outwards  on  the  sides  of  the  neck. 
They  are  of  equal  sizes.  They  run  near  the 
edges  of  the  trachea,  and  continually  diverge 


24 


from  each  other,  till  they  reach  the  level  of  the 
superior  part  of  the  larynx.  Here  they  are 
divided  into  external  and  internal  carotids. 

The  relations  of  the  common  carotids  to  the 
parts,  near  which  they  pass,  constitute  a most 
important  part  in  surgical  anatomy.  They 
are  as  follows. 

On  the  fore  part,  the  left  carotid  being  longer 
than  the  right  is  covered  at  its  origin  by  the  left 
subclavian  vein,  the  thymus  gland  and  the 
clavicle.  Both  the  carotids  afterwards  corres- 
pond to  the  interval  between  the  muscles 
sterno-mastoideus  on  the  outside,  sterno  and 
thyreo  andomo-hyoideus  on  the  inside.  These 
muscles  separate  the  carotid  artery  from  the 
platysma-myoides,  especially  at  the  lower  part 
of  the  neck.  At  die  upper  part,  the  artery  is 
near  to  the  platysma-myoides. 

On  the  back  part,  each  of  the  carotids  cor- 
responds with  the  spine,  from  which  they  are 
separated,  only  by  the  muscles  rectus  anterior 
and  longus  colli,  and  low  down,  by  the  inferior 
thyroid  artery. 

On  the  inside,  the  carotid  correspond  with 
the  trachea,  larynx  and  thyroid  gland.  The 


25 


latter  sometimes  extends  over  them,  especially 
in  females. 

On  the  outside,  the  carotid  has  the  inter- 
nal jugular  vein,  the  nerves  par  vagum  and 
inferior  branch  of  the  superior  cervical  gan- 
glion, behind  the  jugular.  Numerous  lym- 
phatic glands,  situated  along  the  course  of  the 
sterno-mastoideus  ; the  jugular  vein  and  the 
nerves  also  surround  this  artery. 

The  external  and  internal  carotids,  which 
are  the  divisions  of  the  common  carotid,  arise 
from  it  near  the  superior  'edge  of  the  thyroid 
cartilage.  The  external  belongs  wholly  to  the 
face  and  cranium ; the  internal  to  the  brain  and 
eye.  Their  proportional  size  varies  at  diffe- 
rent ages.  In  infancy,  when  the  bulk  of  the 
cranium  exceeds  that  of  the  face,  the  internal 
carotid  is  largest.  In  the  adult,  when  the  cra- 
nium and  face  are  nearly  equal,  there  is  no 
great  difference  between  the  two  arteries. 

Originating  together,  they  ascend  parallel  to 
each  other  till  they  reach  the  digastric  muscle. 
In  this  short  course  they  are  covered  by  the 
sterno-mastoid  muscle,  the  inferior  part  of  the 


26 


parotid  gland,  and  by  many  lymphatic  glands. 
The  internal  carotid  is  more  superficial  at  this 
part  than  the  external. 

Below  the  digastric  muscle,  these  two  arte- 
ries change  their  direction.  The  internal  runs 
backward  to  enter  the  cranium.  The  external 
makes  a curve  below  the  digastric,  approaches 
the  angle  of  the  jaw,  then  ascends  vertically 
between  the  side  of  the  jaw  and  the  external 
ear,  being  covered  completely  by  the  parotid 
gland. 

EXTERNAL  CAROTID  ARTERY. 

This  artery  gives  out  a great  number  of 
branches.  The  smaller  ones  are  distributed 
to  all  the  surrounding  parts.  The  principal 
and  the  only  branches  that  are  constantly 
found  are  in  number  eight ; viz. — 

1.  Superior  Thyroid.  2.  Sub-Lingual.  3. 
Facial.  4.  Ascending  Pharyngeal.  5.  Oc- 
cipital. 6.  Posterior  Auricular.  7.  Tempo- 
ral. 8.  Internal  Maxillary. 


27 


1.  The  superior  thyroid,  issuing  near  the 
origin  of  the  trunk,  and  descending  in  a winding 
course  to  the  superior  margin  of  the  thyroid  gland, 
gives  out 

The  Superficial  Ascending  Branch,  running  above  or 
below  the  os  hyoides,  and  there  forming  an  arch  with  the 
branch  from  the  opposite  side.  This  again  divides  into 

The  Superficial  Descending  Branch,  running  downwards, 
and  dividing  into  several  branches,  with  various  communi- 
cations. These  are  distributed  to 

The  sterno  mastoid,  platysma-myoideus,  the  thyroid 
cartilage,  the  hyo  and  crico  thyroidei  muscles,  and  the 
middle  and  lowest  constrictor  muscles  of  the  pharynx. 

The  Laryngeal  Branch. — Larger,  and  often  proceeding 
from  the  superficial  ascending  branch.  It  hides  itself, 
"with  its  attending  nerve,  between  the  cricoid  and  the  thy- 
roid cartilages  ; or  penetrates  the  membranous  interstice 
between  the  thyroid  cartilage  and  the  os  hyoides;  or  even 
sometimes  runs  to  the  interior  part  of  the  larynx,  through 
a passage  peculiar  to  itself  in  the  thyroid  cartilage,  and  at 
last  sends  olf 

The  Thyroid  Branch — inosculating  in  the  substance  of 
the  gland  itself  with  the  thyroid  branch  of  the  inferior 
thyroid  artery,  and  also  by  various  twigs  with  the  branch 
from  the  opposite  side. 

2.  The  LINGUAL,  OR  SUBLINGUAL  ARTERY, 
winds  above  the  os  hyoides,  forwards,  upwards, 
and  inwards,  to  the  tongue.  At  its  commencement, 
it  either  passes  over,  or  is  covered  by  the  hyoglos- 
sus ; then  is  concealed  by  the  genioglossus.  It 
gives  olf, 


28 


The  Sublingual — the  superficial  branch  of  the  divided 
trunk,  rising  to  the  symphysis,  between  the  sublingual 
glands  and  the  gpniohyoideus,  often  penetrating  the  mylo- 
hyoideus,  and  losing  itself  in  the  integuments  of  the  chin. 
If  larger,  it  often  supplies  the  place  of  the  submental  ar- 
tery. In  this  course  it  sends  off  many  irregularly  disposed 
branches  ; of  which  the  most  remarkable  are, 

Kanina — a large  branch,  going  off  at  an  obtuse  aDgle 
from  the  trunk.  It  runs  tortuously  betweeu  the  fibres  of 
the  genio-glossus  to  the  surface  and  point  of  the  tongue, 
passing  along  the  middle,  on  the  inferior  side. 

3.  The  LABIAL,  EXTERNAL  MAXILLARY, 
facial,  or  angular — Concealed  by  the  stylo- 
hyoideus,  and  the  tendon  of  the  digastric.  Ascends, 
in  a tortuous  manner,  forwards,  through  the  de- 
pression, for  the  maxillary  gland,  and,  winding 
above  the  maxilla,  follows  the  anterior  margin  of 
the  masseter; — afterwards  branches  out,  under  the 
zygomatic  muscles,  in  serpentine  windings,  upon 
the  face  and  the  sides  of  the  mouth  and  nose.  The 
numerous  branches  proceeding  from  this  artery 
are  divided  into  two  classes  : the  first,  compre- 
hending those  arteries  that  leave  the  trunk  before 
it  reaches  the  maxilla ; the  second,  the  branches 
distributed  on  the  face  itself. 

The  Ascending  Palatine — covered  by  the  styloid  mus- 
cles— lies  upon  the  sides  of  the  pharynx,  near  the  external 
margin  of  the  internal  pterygoid  muscle.  Twigs  being 
sent  from  it  to  these  muscles,  to  the  tongue,  the  tonsils; 
and  the  Eustachian  tube,  it  is  divided,  near  the  sides  of 
the  levator  palati,  into 


29 


Th£  Tonsillar  Branch — sometimes  wanting-^near  the 
insertion  of  the  stylo.glossus  penetrates  the  lateral  parts 
of  the  pharynx  to  the  tonsils,  and  exhausts  itself  in  nume- 
rous small  branches,  spreading  on  their  surface,  and 
reaching  to  the  tongue. 

The  Pterygoid  Branch — often  double — distributed  to 
the  internal  pterygoid,  the  mylohyoideus,  the  superior 
constrictors,  the  constrictors  of  the  isthmus  of  the  fauces, 
and  sometimes  to  the  tongue. 

The  Submental  Branch — goes  out  near  the  bend  of  the 
trunk,  above  the  maxilla,  between  the  anterior  part  of  the 
digastric,  the  mylohyoideus,  and  the  margin  of  the  max- 
ilia,  almost  to  the  symphysis  of  the  chin.  When  it  sup- 
plies the  place  of  the  sublingual,  it  distributes  a great 
abundance  of  twigs,  and  commonly 

The  Masseteric  Branch — United  with  a branch  of  the 
temporal  artery  of  the  same  name  upon  the  surface  of  this 
muscle. 

The  Inferior  Labial,  or  Superficial  Branch — rises,  often 
double,  from  the  trunk,  goes  forwards,  and,  having  sent 
branches  to  the  buccinator,  the  depressors  of  the  angle  of 
the  mouth  and  lips,  and  the  orbicular,  distributes  others, 
uniting  with  the  inferior  labial  of  the  opposite  side,  with 
the  inferior  coronary,  and  the  inferior  maxillary ; and 
then  passes  under  the  depressor  of  the  angle  of  the  mouth 
to  the  inferior  lip,  dividing  into  two,  and  sometimes  pro- 
ducing the  inferior  coronary  of  the  lip. 

The  Coronary  of  the  Inferior  Lip — goes  off  near  the 
angle  of  the  mouth,  and,  covered  by  the  depressor  of  the 
angle  and  the  orbicular,  proceeds  towards  the  cavity  of 
the  mouth,  in  a winding  and  transverse  direction,  under 
the  membrane  of  the  mouth,  to  its  fellow  of  the  opposite 
side,  with  which  it  inosculates.  From  this  are  distri- 
buted, 

The  Coronary  of  the  Superior  Lip — like  the  preceding, 
but  larger  and  more  tortuous,  passes  under  the  greater 


30 


zygomatic  and  the  orbicular  muscles,  runs  along'the  mar- 
gin of  the  superior  lip,  and  gives 

Two  or  three  branches,  uniting,  under  the  levator  labii 
superioris  proprius,  with  the  infraorbital,  and  other  small- 
er branches  perforating  this  levator  muscle,  and  uniting 
also  with  the  palpebral  arteries. 

4.  The  ASCENDING  PHARYNGEAL  ARTERY 
of  Haller — issues  near  the  lingual,  or  from  the 
bifurcation  of  the  carotid,  but  more  posteriorly 
from  the  trunk.  The  auricular  excepted,  it  is  the 
smallest  of  the  branches.  It  is  united  by  the  tela 
cellulosa  to  the  long  anterior  rectus  muscle,  and 
rises  anteriorly  towards  the  foramen  lacerum, 
through  which  it  passes  to  be  lost  in  the  dura  ma- 
ter. The  branches  which  go  off  in  its  ascent  may 
be  divided,  in  regard  to  their  situation, 

1st.  Into  those  passing  inwards,  viz. 

An  Inferior  Pharyngeal  Branch — stretching  down,  and 
and  supplying  the  lower  part  of  the  muscular  sac. 

A Middle  Pharyngeal  Branch — distributing  many  twigs 
in  the  region  of  the  larynx,  pharynx,  and  Eustachian  tube, 
after  having  united  itself  with  the  superior  thyroid  artery. 

A Higher  Pharyngeal  or  Palatine  Branch — distributing 
some  twigs  to  the  superior  constrictors,  the  stylopharyn- 
geus,  the  Eustachian  tube,  and  the  pendulous  velum; 
others  to  the  rectus  minor,  the  cuneiform  bone,  the  carti- 
lage occupying  the  anterior  part  of  the  foramen  lacerum — 
and  others  to  the  internal  parts  of  the  nostrils  and  the 
ptery'goid  canal. 

2d.  Those  passiog  Outwards. — Of  which  the  most 
remarkable  are, 

Branches  to  the  first  intercostal  ganglion  and  the  par 
vagum. 


31 


Branches  to  the  sternomastoid  and  the  conglobate  glands 
of  the  neck. 

I 

A branch  passing  through  the  opening  with  the  jugular 
vein,  and  extending  its  minute  twigs  even  to  the  cavernus 
sinus. 

5.  The  occipital  artery — passes  trans- 
versely before  the  jugular  vein,  above  the  rectus 
lateralis,  proceeding  between  the  transverse  pro- 
cess of  the  atlas  and  the  mastoid  process,  to  the 
back  part  of  the  neck,  and  rises,  in  many  wander- 
ing branches,  to  the  occiput.  In  its  course  it  is 
covered  by  the  digastric,  the  trachelomastoid,  the 
splenius,  and  complexus  ; and  becomes  subcuta- 
neous as  it  reaches  the  occiput.  Its  branches 
are, 

One  to  the  digastric  and  stylohyoideus. 

Branches  to  the  glands  of  the  neck  and  the  sternomas- 
toid, inosculating  with  the  ascending  thyroid  artery. 

A Meningeal  Branch — which  enters  the  cranium  along 
with  the  jugular  vein,  and  is  distributed  to  the  surface  of 
the  dura  mater  of  the  cerebellum. 

An  Auricular  Branch — distributed  to  the  lesser  lobe 
and  the  helix,  and  sometimes  behind  on  the  concha. 

The  artery,  having  now  bent  towards  the  vertex  of  the 
head,  branches  go  off  in  a retrograde  course  to  the  sple- 
nius and  complexus  ; whilst  other  branches  are  so  exten- 
sively ramified,  that  a great  number  of  them  inosculate 
with  the  higher  twigs  of  the  temporal  artery.  Of  these, 
one  perforates  the  occipital  ridge,  and  another  the  poste- 
rior mastoid  hole — both  of  them  going  to  the  dura  mater. 

6.  The  POSTERIOR  AURICULAR,  or  stylo- 
mastoid.— This  artery  rises  from  the  trunk  in 


32 


the  parotid  gland,  above  the  digastric  muscle,  and 
before  the  styloid  process,  and  passes  transversely 
to  the  ear.  As  it  ascends  in  a curved  direction 
behind  the  ear,  it  inclines  to  the  posterior  part  of 
the  squamous  bone,  inosculating,  first  with  the 
temporal,  and  then  with  the  occipital  arteries.  It 
divides  into 

Numerous  branches,  going  to  the  parotid  gland,  the 
digastric  and  sternomastoid  muscles. 

A branch,  passing  through  a particular  opening  in  the 
meatus  auditorius  of  infants,  is  distributed  to  its  mem- 
brane. 

The  Stylomastoid  Branch — passing  outward  to  the  sty- 
lomastoid hole,  where  it  enters,  and  exhibits  the  following 
branches : — 

Minute  branches  to  the  sternomastoid  muscle,  the  skin, 
and  -rertexof  the  head. 

Branches  behind  the  ear  to  the  posterior  auricular,  the 
occipital  and  splenius  muscles,  and  distributed  more 
deeply  to  the  mammillary  process,  the  pericranium,  and 
the  occipital  bone. 

A branch,  winding  on  the  posterior  part  of  the  con- 
cha of  the  ear,  and  sending  twigs  to  the  cartilage,  to  inos- 
culate with  the  ramuli  of  the  anterior  auricular  artery. 

Higher  branches,  spreading  under  and  above  the  apone- 
urosis of  the  temporal  muscle,  and  inosculating  before 
with  the  temporal,  and  behind  with  the  occipital  branches. 

7.  The  TEMPORAL,  OR  SUPERFICIAL  TEM- 
PORAL.— This  artery,  concealed  at  first  in  the 
parotid  gland,  rises  in  a straight  line  above  the 
zygomatic  arch,  between  the  maxilla  and  meatus 
auditorius,  and  is  at  last  extensively  ramified  on  the 


33 


aponeurosis  of  the  temples  and  the  neighbouring 
parts.  In  this  course  are  sent  off 

A number  of  branches  to  the  parotid  gland,  equally 
irregular  in  size  and  number. 

The  Articular  Artery  of  the  Maxilla — running  to  the 
posterior  part  of  the  meatus  auditorius;  sending  branches 
to  the  articular  cartilage,  aud  transmitting  two  twigs  along 
the  portiodura,  through  the  fissureof  the  articulation,  where 
they  reach  the  muscle  of  the  malleus,  and,  inosculating 
with  the  stylomastoid,  form  the  other  half  of  the  coronary 
artery  of  the  tympanum. 

The  Transverse  Artery  of  the  Face— rising  under  the 
zygoma  from  the  parotid  gland,  it  proceeds  transversely 
to  the  face  along  with  the  salivary  duct.  In  this  course, 
if  double,  it  gives  branches  to  the  parotid  gland,  the  arti- 
culation of  the  maxilla,  the  masseter,  the  skin,  the  zygo- 
maticus,  and  the  orbicularis  palpebrarum.  It  inosculates 
with  the  alveolar,  palpebral,  infraorbital,  and  coronary 
arteries  of  the  upper  lip  ; and  sometimes  gives  rise  to  mas- 
seteric branches. 

The  Middle  or  Deep  Temporal  Branch — sent  off  below 
the  zygoma.  This  branch  passes  over  the  zygomatic  arch, 
and  is  immediately  covered  by  the  aponeurosis  of  the  mus- 
cle, where  it  extends  to  the  anterior  part  of  the  temporal 
muscle,  to  the  external  angle  of  the  orbit,  and  inosculates 
with  the  palpebral  artery. 

The  Anterior  Auricular  Arteries — rising  above  the 
origin  of  the  middle  temporal.  Some  of  these  perforate 
the  meatus  auditorius,  and  form  a retiform  plexus  with 
the  posterior  auricular  artery  ; others  go  to  the  helix  and 
antihelix,  the  anterior  auricular  muscle,  and  meatus  audi- 
torius. 

The  Orbicular  Branch — rising  often  from  the  temporo- 
frontal  artery,  passing  above  the  zygomatic  arch,  sends  a 
small  branch,  in  a tortuous  direction,  to  the  external  can- 
thus  of  the  eye,  which,  running  under  the  orbicularis, 

4 


34 


reaches  the  internal  angle  of  the  orbit.  In  this  course,  it 
inosculates  with  the  palpebral  and  frontal  branches,  and, 
with  the  frontal,  forms  the  superciliary  arch. 

The  Temporo  frontal , or  Internal  Anterior  Branch — 
distributed  extensively  towards  the  forehead,  and  some- 
times reaching  as  far  as  the  glabella.  It  sends  branches 
which  rise  almost  at  right  angles  from  the  trunk,  to  the 
orbicular,  corrugator,  frontal  muscles,  and  aponeurosis. 

The  Temporo-occipital,  orExternal  Posterior  Branch — 
bending  towards  the  ear,  backwards  and  behind  it,  form- 
ing, as  it  were,  a continuation  of  the  trunk — is  distri- 
buted, in  numerous  ramifications,  to  the  occipital  and  late- 
ral parts  of  the  head  ; inosculates  with  the  occipital  about 
the  lambdoidal  suture  with  the  temporo-frontal  before, 
and  above  with  the  branches  stretching  from  the  opposite 
side. 

8.  The  internal  maxillary. — This  arte- 
ry is  larger  than  the  temporal : it  rises  above  the 
lateral  ligament  of  the  maxilla,  about  the  middle 
of  the  ramus  of  the  inferior  maxillary  bone,  before 
the  external  pterygoid ; and,  bending  inwards, 
forwards,  and  downwards,  is  concealed  under  the 
maxilla.  It  then  rises  obliquely  upwards  and  for- 
wards, to  the  space  lying  between  the  tuber  max- 
illare  and  the  pterygoid  process ; and  as  it  pro- 
ceeds in  a tortuous  manner,  it  is  lost  here  in  three 
or  four  branches,  or  rather  in  the  spheno-maxilla- 
ry  fissure.  In  this  course  it  gives 

The  Deep  Auricular  Artery — going  to  the  posterior 
part  of  the  meatus  auditorius,  and  giving  twigs  to  this 
and  the  neighbouring  glands.  It  is  sometimes  wanting. 


35 


The  Artery  of  the  Tympanum — which,  haring  sent  ra- 
muli  to  the  fat  of  the  maxillary  articulation,  passes  through 
the  fissure  of  Glasserus  to  the  anterior  muscle  of  the  mal- 
leus. 

The  Small  Meningeal  Artery — running  towards  the 
basis  of  the  skull,  parallel  to  the  middle  meningeal.  It 
gives  in  its  course  branches  to  the  external  pterygoid, 
to  the  palatine  muscles,  and  to  the  third  branch  of  the 
fifth  pair  of  nerves.  It  then  passes  through  the  foramen 
ovale,  to  the  membranes  of  the  receptacle,  between  the 
pterygoid  process  and  the  circumflex  muscle. 

The  Middle  Meningeal  Artery — passing  in  a straight 
direction  to  the  foramen  spinosum,  where  it  enters  this 
hole;  and  is  there  so  ramified  upon  the  surface  of  the  du- 
ra mater,  that  some  branches  are  carried  transversely  un- 
der the  temporal  bone  to  the  occipital,  others  to  the  pos- 
terior sinus  of  the  falx,  while  others  bend  a little  more 
anteriorly.  All  of  these  have  frequent  anastomosings  with 
one  another,  as  also  with  the  posterior  meningeal  branches 
rising  from  the  vertebral  an'd  occipital  arteries,  and  with 
the  anterior  branches  from  the  ophthalmic.  Before  reach- 
ing the  foramen  spinosum,  it  sometimes  gives  branches  to 
the  sphenoid  bone,  and  through  that  bone  to  the  dura  ma- 
ter, and  others  to  the  external  pterygoid,  and  the  muscles 
of  the  Eustachian  tube.  Having  passed  the  foramen  spi- 
liosum,  it  sends 

The  meningeal  artery  which  sometimes  sends  off-  the 
lachrymal  artery  within  the  cranium. 

The  Inferior  Maxillary  Artery — going  down,  in  com- 
pany with  the  nerve  of  the  same  name,  to  the  iuframax- 
illary  canal.  As  it  enters  the  canal  along  with  the  nerve, 
it  sends  branches  to  the  internal  pterygoid  and  the  mylo- 
hyoideus;  and  is  so  distributed  on  the  canal  of  the  bone, 
that  some  posterior  branches  go  to  the  dentes  molares  and 
the  bone  itself,  while  anterior  twigs  enter  the  alveolar 
process  of  the  incisores:  then  passing  through  the  infra- 


36 


maxillary  hole,  it  inosculates  with  the  labial  branches, 
and  is  distributed  to  the  adjacent  muscles  and  lip. 

Pterygoid  Branches — varying  in  number — and  distri. 
buted,  both  superficially  and  more  deeply,  on  the  ptery- 
goid and  buccinator  muscles. 

The  Deep  External  Temporal  Artery — before  the  trunk 
is  concealed  by  the  zygoma,  gives  a branch,  which,  in  its 
ascent,  rests  upon  the  tendon  of  the  temporal  muscle, 
and  terminates  in  this  muscle  and  adjoining  parts ; 
while  another,  which  some  call  the  masseteric , is  sent  out* 
wards  and  forwards  between  the  processes  of  the  max* 
ilia,  to  the  external  pterygoid  and  masseter  muscles. 

The  Deep  Internal  Temporal  Artery — rising  in  that 
part  where  the  trunk  proceeds  transversely  near  the  an- 
trum Highmorianum,  terminating  in  the  temporal  muscle, 
and  transmitting  a twig  through  the  cheek-bone, to  supply 
the  fat  and  periosteum  of  the  orbit. 

The  Buccal  or  Artery  of  the  Cheek — irregular  in  its 
origin,  arising,  sometimes  from  the  external  deep  tem- 
poral artery,  sometimes  from  the  alveolar,  and  sometimes 
from  the  infraorbital — penetrates  the  buccinator;  and, 
winding  on  its  surface,  gives  branches  to  the  zygomaticus, 
the  levator,  the  glands,  and  the  adipose  substance. 

The  Alveolar  Artery — proceeding  in  a tortuous  direc- 
tion, above  the  alveolar  processes  and  the  superior  maxil. 
lary  bone,  towards  the  cheek  and  face — where  it  gives 
The  Infraorbital  Artery — rising  in  the  spheno-maxil- 
lary  fissure,  near  the  infraorbital  groove;  and,  passing 
along  this  canal,  emerges  at  last  upon  the  face  through 
the  infraorbital  hole.  Before  the  trunk  reaches  the  canal, 
branches  are  distributed  to  the  fat  and  dura  mater  of  the 
orbit,  to  the  lachrymal  gland,  and  to  the  inferior  oblique 
muscle  of  the  eye.  From  the  canal, 

The  Superior  Palatine , Descending , or  Pterygopala- 
tine Artery — rising,  often  double,  from  the  trunk,  that  is 
divided  into  three  branches  at  the  sphenomaxillary  fissure. 
It  enters  the  pterygopalatine  canal ; and  there,  if  not 
sooner,  divides  into  two  branches: 


37 


A Posterior  Branch — turning  backwards  through  the 
posterior  palatine  hole,  going  to  the  extremity  of  the  pa- 
latine bone  and  the  velum  palati,  and  communicating  with 
the  ascending  palatine  branch.  An  Anterior  Branch — 
larger  than  the  last,  passing  forward  under  the  roof  of  the 
mouth,  and  forming  a vascular  plexus  in  the  palate.  A 
single  twig  ascends  through  the  foramen  incisivum  to  the 
inner  side  of  the  nose,  or  inosculates  with  the  nasal  branch 
as  it  passes  down. 

The  Highest  Pharyngeal  Branch — rising  in  the  place 
already  mentioned ; stretching  behind  the  sphenoidal  si- 
nuses to  the  upper,  posterior,  and  lateral  parts  of  the  pha- 
rynx— where  it  gives 

A branch,  going  to  the  pterygoid  hole,  and  inosculat- 
ing with  a branch,  rising  either  from  the  internal  carotid, 
the  pharyngeal,  or  the  middle  meningeal  arteries. 

The  Nasal  Artery— the  last  branch  of  the  trunk,  and 
often  double,  passing  through  the  spheno-palatine  hole, 
and  dividing,  at  the  superior  and  posterior  part  of  the  nose, 
into 

A small  branch,  going  to  the  posterior  ethmoid  cells. 

Branches  to  the  sphenoidal  sinuses. 

Larger  branches  to  the  septum  of  the  nose. 

A large  branch,  passing  through  the  superior  and  infe- 
rior spongy  bones  to  the  bottom  of  the  nose;  giving  twigs 
to  the  antrum  and  the  membranes  of  the  nostrils,  and  in- 
osculating with  the  anterior  palatine  branch  as  it  passes 
through  the  foramen  incisivum. 

DISTRIBUTION  OE  THE  INTERNAL  CAROTID,  OR  CERE- 
BRAL ARTERY. 


This  artery,  as  it  rises  to  its  canal,  is  con- 
nected before,  by  means  of  cellular  substance, 
to  the  par  vagum  and  intercostal  nerves;  and 


38 


behind,  to  the  rectus  anticus  muscle.  Some- 
times it  forms  above  the  vertebrae  a larger  or 
a smaller  projecting  curvature.  In  this  course 
no  branches  are,  in  general,  given  off.  At 
last  it  enters  the  foramen  carotideum ; and, 
passingalong  this  canal,  undergoes  many  re- 
markable inflections.  On  its  first  entering  the 
foramen,  where  it  forms  an  obtuse  angle,  the 
artery  proceeds  upwards,  inwards,  and  a little 
forwards.  As  it  begins  to  rise  from  the  canal 
forwards  and  upwards,  the  second  curvature 
appears  very  obtuse.  Having  at  last  reached 
the  posterior  part  of  the  sella  turcica,  it  is  so 
inflected  in  the  cavernous  sinus  or  receptacle, 
as  to  run  in  a horizontal  direction  to  the  an- 
terior clinoid  process.  It  here  rises  perpen- 
dicularly, perforates  the  internal  surface  of 
the  dura  mater,  and  proceeds,  near  the  bot- 
tom of  the  brain,  backwards  to  the  cerebrum. 
Through  this  course,  the  following  branches 
are  chiefly  remarkable : 

One  to  the  pterygoid  canal,  inosculating  with  a branch 
of  the  highest  pharyngeal  from  the  internal  maxillary. 

A branch,  spreading  out  in  the  canal  itself,  going  to 
the  cavity  and  promontory  of  the  tympanum,  and  anasto. 


39 


mosing  with  a branch  of  the  meningeal,  passing  under  the 
fissure  of  the  aqueduct. 

The  POSTERIOR  ARTERY  of  the  RECEPTACLE 

or  cavernous  sinus — rising  from  the  trans- 
verse part  of  the  carotid  concealed  in  the  recepta- 
cle, and  going  to  that  part  of  the  dura  mater  which 
covers  the  posterior  clinoid  processes  and  the 
cuneiform  occipital  process ; inosculating  with 
branches  of  the  vertebral  artery  rising  without  the 
cranium,  and  entering  it  through  the  foramen  mag- 
num. 

Many  branches,  distributed  extensively  on  the  dura 
mater. 

Branches  to  the  4th,  5th,  and  6th,  pairs  of  nerves. 
Branches  to  the  pituitary  gland,  its  periosteum,  and  the 
cuneiform  bone. 

The  ANTERIOR  ARTERY  of  the  RECEPTACLE 
• — rising  above  the  root  of  the  intercostal  nerve. 
Some  anatomists,  from  supposing  the  intercostal 
to  have  its  origin  from  the  first  branch  of  the  fifth 
pair,  have  mistaken  this  artery  for  a nerve. 

Branches  to  the  3d,  4th,  and  the  three  divisions  of  the 
5th  pair,  with  which  they  go  out. 

Many  branches  to  the  dura  mater  of  the  receptacle, 
near  the  sphenoidal  fissure,  and  some  to  the  pituitary 
gland. 

The  ophthalmic  artery — rising  in  the  an- 
gle where  the  carotid  artery  leaves  the  sphenoid 
bone,  near  its  anterior  clinoid  processes,  and  run- 
ning with  the  nerve  which  accompanies,  and  rests 


40 


upon  it,  through  the  optic  hole,  to  the  orbit  of  the 
eye.  In  mentioning  its  branches,  and  their  sub- 
divisions, I shall  observe  the  order  which  Nature 
generally  points  out  in  sending  them  from  the 
trunk.  After  lying  by  the  external  side  of  the  op- 
tic nerve,  it  passes  obliquely  forwards  over  the 
nerve ; and  reaching  the  internal  angle  of  the 
eye  above  its  adductor  muscle,  divides  into  two 
branches ; and  these  again  into  the  following 
smaller  branches  : 

The  Lachrymal — rising  from  the  opthalmic  artery, 
about  two  lines  after  it  enters  the  orbit,  between  the  ab- 
ductor and  the  levator  ; and  then  running  above  the  ab- 
ductor, proceeds  to  the  lachrymal  gland.  It  sometimes 
goes  oft'  from  the  middle  meningeal  artery. 

The  Supraorbital , or  Superior  Muscular  Branch — 
rises,  while  the  trunk  crosses  the  nerve,  under  the  peri- 
osteum of  the  orbit;  then  bending  to  the  levator  palpe- 
brre,  proceeds  forwards,  and,  after  passing  through  the  su- 
praorbitary  hole,  is  distributed  upon  the  forehead,  in  two 
separate  branches. 

The  Central  Artery  of  the  Retina — rising  from  the  in- 
ferior side  of  the  ophthalmic  trunk  as  it  lies  upon  the  op- 
tic nerve  ; or  sometimes  from  the  ciliary  arteries.  It  then 
sinks  into  the  nerve  ; runs  along  its  axis;  penetrates,  often 
double,  the  medullary  expansion  of  the  retina;  and, 
branching  into  many  new  divisions,  is  extensively  ramified 
on  its  internal  surface.  Of  these,  some  extending  as  far 
as  the  corpus  ciliare,  form  a circle  between  it  and  the  vi- 
treous humour,  giving  twigs  to  the  crystalline  lens;  while 
a particular  branch  passes  through  the  centre  of  the  vitre- 
ous humour  to  the  posterior  side  of  the  lens. 

The  Long  Internal  Ciliary  Artery. 

The  Inferior  Muscular  Artery — rising  from  the  trunk 


41 


at  the  interior  margin  of  the  optic  nerve,  very  often  be- 
tween the  ciliary  arteries,  and  transmitted,  either  under 
the  eye,  or  above  the  adductor  muscle,  to  the  inferior  pal- 
pebra. 

The  Inferior  Ciliary  Artery. — This  is  wanting  some- 
times. 

The  three  ciliary  arteries  mentioned  above,  commonly 
arise  from  the  ophthalmic  artery,  in  such  a way,  that  the 
external  follows  the  external  margin  of  the  nerve;  the  in- 
ternal, the  inner  margin  ; while  the  inferior,  with  similar 
windings,  runs  near  the  inferior  muscular,  along  the  lower 
margin  of  the  nerve.  There  are  sometimes  six  ciliary  ar- 
teries, which,  whether  they  arise  from  the  ophthalmic  or 
its  branches,  spread  into  several  ramifications,  and  enter 
the  sclerotic  coat. 

The  Posterior  Ethmoidal  Artery — running  between  the 
levator  and  adductor  muscles,  above  the  greater  oblique; 
enters  the  posterior  orbitary  hole;  passes  through  the  cri- 
briform plate  into  the  cranium  ; and,  reaching  near  the  du- 
ra mater,  inosculates  with  the  anterior  ethmoidal  branches. 
The  rest  of  the  trunk  is  distributed  to  the  nose. 

The  Anterior  Ethmoidal  Artery — rises  where  the  trunk, 
as  it  passes  over  the  fourth  pair  of  nerves,  reaches  the 
trochlea.  It  then  enters  the  anterior  orbitary  hole,  and 
proceeds  into  the  cranium  through  a peculiar  opening  near 
the  ethmoid  cells,  distributing  some  ramuli,  to  the  nose. 

The  Inferior  Palpebral  Artery— rising  often  along  with 
the  superior  palpebral,  at  that  place  where  the  trunk  ge- 
nerally  leaves  the  tendon  of  the  superior  oblique. 

The  Superior  Palpebral  Artery — to  the  upper  eyelid, 

The  Nhsal  Artery — rising  over  the  superior  part  of  the 
lachrymal  sac  and  the  ligament  of  the  eye-lids,  goes  to  the 
nose. 

The  Frontal  Artery — at  first  subcutaneous — passes  over 
the  orbicular  muscle,  and  then  sinks  in  the  corrugator. 


The  communicating  artery.— -This,  along 

5 


42 


with  the  deep  branch  of  the  vertebral  artery  of  the 
cerebrum,  forms  the  circle  of  Willis.  It  is  tor- 
tuous ; but  when  it  leaves  the  tunica  arachnoides, 
proceeds  in  a straight  line  backwards  and  inwards, 
along  the  sides  of  the  corpora  mammillaria,  near  the 
infundibulum,  where  it  reaches  the  artery  already 
mentioned,  and  there  forms  an  obtuse  angled  qua- 
drangular space. 

The  ANTERIOR  CAROTID  ARTERY,  Or  AR- 
TE RI A callosa. — The  internal  carotid,  at  that 
place  where  the  anterior  lobe  of  the  brain  is  sepa- 
rated from  the  posterior,  divides  into  two  branches 
of  nearly  equal  size ; of  which  the  anterior  pro- 
ceeds immediately  inwards,  and  a little  forwards; 
then  bends  above  the  corpus  callosum,  between 
the  hemispheres,  to  the  posterior  lobes  of  the 
brain  : in  which  course  it  gives 

Branches  to  the  optic  and  olfactory  nerves. 

A Communicating  Branch — inosculating  with  its  fellow 
of  the  opposite  side.  This  brauch  is  short  and  transverse. 

Branches  to  the  inferior  side  of  the  anterior  lobe,  and 
to  its  flat  and  internal  surface,  where  the  falx  separates 
the  two  hemispheres.  They  run  in  circuitous  windings, 
penetrate  deeply  the  substance  of  the  brain,  and  in  many 
places  inosculate  with  the  posterior  carotid. 

Many  branches  to  the  corpus  callosum  and  adjacent  ce- 
rebrum, sinking  into  the  posterior  lobe,  forming  inoscula- 
tions with  the  posterior  carotid  and  vertebral  arteries,  and 
extending  even  to  the  tentorium. 

The  posterior  carotid,  or  the  ARTE- 
RY of  the  fossa  sylviana. — This  second  di- 
vision of  the  trunk  enters  the  fossa  Sylvii  that  se- 


43 


parates  the  anterior  and  posterior  lobes,  and  gives 
to  each  numerous  superficial  branches,  spreading 
on  the  circumvolutions  of  the  cerebrum,  and  seve- 
ral deep  ones,  ramified  backwards. 

Branches  to  the  optic  nerves  and  choroid  plex- 
us. Branches  to  the  pia  mater,  covering  the  basis 
of  the  brain. 

SUBCEAVIAN  artery  and  its  branches. 

The  lower  part  of  the  neck,  the  shoulder 
and  upper  extremity  receive  their  blood  from 
the  subclavian  artery.  This  large  vessel  is 
continued  from  the  clavicle,  which  gives  it  its 
name,  through  the  axilla  and  arm  to  the  elbow 
in  a single  trunk ; yet  in  this  course,  it  receives 
the  three  names  of  subclavian,  axillary  and 
brachial. 

The  subclavian  arteries  of  the  right  and 
left  sides  do  not  arise  exactly  in  the  same 
manner ; for  the  right  comes  from  the  arteria 
innominata,  at  the  side  of  the  trachea ; while 
the  left  arises  from  the  aorta  itself,  near  the 
termination  of  its  curvature. 

Their  position , length , direction , and  rela- 
tions, differ.  These  differences,  in  an  artery 


44 


so  considerably,  and  which  is  sometimes  the 
subject  of  most  important  operations,  should 
not  be  neglected. 

Position.  The  right  subclavian  rises  from 
the  arteria  innominata  after  that  vessel  has 
passed  an  inch  from  the  aorta.  It  is  the  most 
superficial,  as  the  arteria  innominata  itself 
comes  from  the  arch  of  the  aorta  at  a point 
more  anterior  than  that  where  the  left  sub- 
clavian rises. 

The  left  subclavian  rises  from  the  aorta  a 
primitive  trunk.  It  is  situated  very  deeply, 
because  that  part  of  the  curvature,  which 
gives  it  origin  is  the  most  profound. 

Length.  The  right  is  shorter  than  the  left, 
by  the  whole  length  of  the  arteria  innomi- 
nata. 

Direction.  The  right  runs  obliquely  out- 
wards and  upwards,  as  far  as  the  interval  be- 
tween the  scaleni  muscles.  The  left  ascends 
vertically  even  till  it  comes  close  to  these  mus- 
cles ; then  it  turns  suddenly  outward  to  pass 
between  them. 

Relations.  The  right  is  partially  covered 
at  first  by  the  clavicle,  by  the  sterno-thvroid 


45 


muscle  and  by  the  right  subclavian  vein.  It 
is  afterwards  crossed  by  the  nerve  par  vagum. 
Posteriorly,  it  lies  over  the  spine  and  the 
muscle  longus  colli,  yet  at  a little  distance 
from  them.  Internally,  a triangular  space 
separates  it  from  the  common  carotid.  Ex- 
ternally, it  is  near  the  apex  of  the  lungs. 

The  left  subclavian  is  covered  on  the  fore 
part  by  the  lung  at  its  origin,  then  by  the 
nerve  par  vagum  which  lies  in  the  same  direc- 
tion, instead  of  crossing  it.  It  corresponds 
remotely  with  the  first  rib,  with  the  clavicle, 
and  lastly  with  the  sterno-thyroid  muscle, 
from  which  it  is  separated  by  a distinct  inter- 
val. Posteriorly,  it  lies  immediately  on  the 
spine  and  the  muscle  longus  colli.  Internally, 
it  runs  parallel  with  the  common  carotid. 
Externally,  it  corresponds  directly  with  the 
left  lung. 

When  they  have  reached  the  scaleni  mus- 
cles, the  two  subclavians  are  situated  alike. 
Both  suddenly  take  a transverse  direction, 
in  order  to  enter  between  these  muscles. 
Then  they  change-their  name  and  take  that  of 


46 


axillary.  Immediately  before  this  occurs,  the 
subclavian  gives  out  its  principal  branches. 

A 

These  are  in  number  six, 

Two  inferior,  the  internal  mammary  and  supe- 
rior intercostal ; two  superior,  the  vertebral  and 
inferior  thyroid,  and  two  external,  the  deep  cervi- 
cal and  superficial  cervical.  The  superior  sca- 
pular is  often  given  olf  from  this  artery  also. 

A.  The  INTERNAL  MAMMARY  ARTERY "O- 

o 

ing  off  from  the  lower  and  interior  part  of  the 
trunk,  at  the  highest  part  of  the  pleura,  where, 
ascending  gradually,  and  again  bending  down- 
wards to  the  sternum,  it  reaches  the  margin  of  the 
first  rib,  under  which  it  passes;  and,  running  be- 
tween the  pleura  and  middle  part  of  the  cartilages 
of  the  ribs,  descends  between  the  internal  inter- 
costal and  the  sterno-costal  muscles,  as  far  as  the 
diaphragm.  It  then  passes  between  the  diaphragm 
and  the  ribs,  and,  dividing  into  many  twigs,  is  lost 
under  the  rectus  of  the  abdomen.  From  its  origin 
to  the  third  rib,  it  bends  towards  the  sternum,  then 
gradually  inclines  outwards.  Its  branches  are, 

A Recurrent  Branch — passing  in  the  direction  of  the 
clavicle  to  the  muscles  of  the  neck,  and  distributing  to 
these  muscles  small  irregular  ramuli. 

The  Thymic  Branch — which  is  often  double,  and  varies 
ver\  much  in  the  distribution  of  its  twigs  to  this  gland  : 
which  also  receives  arteries  from  those  of  the  mediastinum 
and  pericardium. 

The  Superior  and  Posterior  Pericardiac  Branch — 


47 


rising  sometimes  from  the  mammary,  and  sometimes  from 
the  subclavian  artery  ; sometimes  from  the  aorta  or  from 
the  common  carotid;  and  as  it  winds  to  the  upper  and 
back  part  of  the  pericardium,  distributes  itself  upon  the 
trachea,  the  glands,  the  coats  of  the  pulmonary  artery,  the 
pericardium,  and  oesophagus. 

Many  Mediastinal  Branches — rising  between  the  third 
and  sixth  ribs  ; some  of  which  go  to  the  thymus  gland,  and 
a larger  one  to  the  diaphragm.  Sternal  Branches — 
spreading  variously  on  the  back  of  the  sternum,  and 
uniting  with  branches  from  the  opposite  side. 

Smaller  branches  to  the  pericardium  and  glands,  lying 
on  the  vena  cava. 

Many  branches  to  the  adjoining  surface  of  the  lungs. 

The  Phrenico-pericardiac  Branch— descending  above 
the  pericardium  to  the  diaphragm,  and  sometimes  stretch- 
ing near  the  ensiform  cartilage  to  the  rectus  muscle. 

The  Musculo -phrenic — rising  in  a large  Branch  at  the 
sixth  interstice  of  the  ribs,  turns  outwards,  between  the 
cartilages  and  the  sternacostal ; then  proceeds  obliquely 
to  the  interstices  pf  the  seventh,  eighth,  and  ninth,  ribs, 
where  it  forms  inosculating  rings  with  the  inferior  inter- 
costal arteries;  and  here  sending  many  twigs  to  the  dia- 
phragm, at  last  spreads  at  the  tenth  rib  on  the  transverse 
muscle  of  the  abdomen. 

A branch,  winding  on  the  surface  of  the  ensiform  carti- 
lage, and  inosculating  with  the  branches  of  the  opposite 
side,  or  going  down  as  far  as  the  rectus  muscle.  Some- 
times passes  through  the  ensiform  process. 

The  Epigastric  Branch. — A continuation  of  the  trunk  ; 
as  it  leaves  the  thorax  by  the  side  of  the  ensiform  carti- 
lage, at  the  seventh  rib,  is  covered  by  the  abdominal  mus- 
cles, and  divided  into 

An  Iternal  Branch — going  down  to  the  rectus  muscle, 
often  as  far  as  the  umbilicus,  and  inosculating  with  twigs 
of  the  epigastric. 

An  External  Branch — going  to  the  transversalis,  and 


48 


inosculating  with  the  epigastric,  intercostal,  and  lumbar 
arteries  ; sometimes  sent  from  the  musculo. phrenic  : and 
if  that  be  smaller,  this  supplies  it  with  many  branches. 

B.  The  Superior  intercostal  artery — 
rises  more  externally  than  the  vertebral,  from  the 
upper  and  posterior  surface  of  the  trunk  ; then 
ascends  with  it  to  the  hollow  that  is  formed  by  the 
anterior  scalenus,  the  surface  of  the  first  rib,  and 
bodies  of  the  vertebras.  It  is  there  suddenly  re- 
flected ; and,  proceeding  to  the  roots  of  the  first 
and  second  ribs  within  the  thorax,  gives, 

Ascending  branches,  irregular  in  number  and 
size,  to  the  scaleni,  the  longus  colli,  and  the 
nerves. 

Brauches  to  the  intercostal  muscles  of  the  first  and  se- 
cond interstices,  which  run  along  the  margins  of  the  ribs, 
forming  circular  inosculations  with  the  higher  thoracic 
branch  and  the  branches  of  the  internal  mammary. 

Numerous  Oesophageal  Branches — 

Branches  sent  through  the  openings  for  the  nerves  to 
the  hollow  of  the  spine,  and  there  distributed  both  to  the 
involu.ee a and  the  medulla. 

Branches  passing  over  the  third  rib,  and  inosculating 
with  twigs  of  the  first  inferior  intercostal. 

Deep  branches,  passing  through  the  intercostal  spaces 
to  the  deep  muscles  of  the  back  and  neck. 

C.  The  vertebral  artery — larger  than 
the  former,  rises  from  the  superior  side  of  the 
subclavian ; and,  ascending  a little  backwards, 
covered  by  the  ganglions  of  the  intercostal  and  the 
cellular  membrane,  reaches  the  perforations  of  the 


49 


transverse  processes  of  the  cervical  vertebras. 
Through  these  it  penetrates,  and,  rising  perpendi- 
cularly from  the  sixth,  or  sometimes  from  the  fifth 
or  fourth  opening,  reaches  the  aperture  of  the  atlas, 
where  it  bends  a little  outwards  ; and  having  pass- 
ed through,  undergoes  another  more  extensive 
flexion  backwards  and  inwards,  by  which  it  is 
carried  transversely  in  a groove,  between  the  occi- 
pital bone  and  the  atlas,  to  the  foramen  magnum. 
Through *this  opening,  having  at  last  entered  the 
cranium,  it  proceeds  upwards  and  forwards,  and  at 
the  basilar  apophysis,  under  the  medulla  oblonga- 
ta, meets,  at  an  acute  angle,  with  the  vertebral 
artery  of  the  opposite  side,  forming  the  basilar  ar- 
tery to  be  distributed  to  the  cerebrum  and  cere- 
bellum. It  gives,  in  this  course, 

Larger  branches,  passing  through  the  intervertebral 
openings  for  the  nerves,  to  the  coverings  of  the  medulla, 
and  inosculating  with  the  anterior  and  posterior  spinal 
branches. 

A branch  going,  with  various  twigs,  from  the  first  bend 
of  the  artery  to  the  rectus  posticus  major  and  minor,  the 
obliquus  major  and  minor,  the  trachelomastoid,  and  com- 
plexus  ; and  inosculating  with  branches  reaching  from  the 
occipital  artery. 

Posterior  Meningeal  Brauches — proceeding  from  the 
second  and  third  flexures,  and  winding  forward  upon  the 
dura  mater  of  the  cerebellum,  as  far  as  the  clinoid  pro- 
cesses and  receptacle,  and  backwards  towards  the  occiput. 

Before  the  formation  of  the  basilar  artery,  there  are 
sent  otf  in  the  cranium  itself — 

1.  The  Inferior  Artery  of  the  Cerebellum — issuing  at  a 
right  angle  from  the  trunk,  near  the  medulla  oblongata, 


50 


between  the  tenth  and  accessory  nerves.  It  not  only 
distributes  many  branches  to  the  lower  surface  of  the 
cerebellum,  but,  being  concealed  between  the  medulla 
oblongata  and  the  crura  of  the  cerebellum,  is  so  sent 
backwards  and  upwards  as  to  terminate  in  the  vermiform 
process  of  the  cerebellum  and  fourth  ventricle. 

2.  Branches  sinking  into  the  furrow  that  separates  the 
corpora  pyramidalia  from  the  tuber  annulare. 

3.  The  Posterior  Spinal  Artery — rising  ofteu  from  the 
inferior  artery  of  the  cerebellum  ; and,  bending  from  the 
anterior  to  the  posterior  surface  of  the  medulla  oblongata, 
descends  tortuously  on  the  spinal  marrow, **id  inosculates 
freely  in  its  descent  with  its  fellow  and  with  other  branches, 
as  they  pass  to  the  medulla  through  the  openings  for  the 
nerves.  It  terminates  on  the  surface  of  the  medulla  at  the 
second  lumbar  vertebra ; and  through  its  whole  course  sup- 
plies, with  minute  twigs,  the  medulla,  and  its  several 
nerves,  as  they  pass  out. 

4.  The  Anterior  Spinal  Artery — rising,  at  an  acute 
angle  from  the  trunk,  near  its  fellow,  and,  descending  in 
a retrograde  course,  proceeds  in  a winding  direction  upon 
the  anterior  surface  of  the  medulla,  inosculating  by  trans- 
verse branches  in  the  region  of  the  neck  and  back  with  the 
artery  of  the  opposite  side,  to  which  it  is  parallel.  The 
two  arteries  at  last  uniting  near  the  termination  of  the 
medulla,  form  a trunk,  which  is  sent  to  the  extremity  of 
the  os  sacrum ; and  which,  if  emptied  of  its  blood, 
assumes  the  appearance  of  a nerve : whence  the  ancient 
error  as  to  a Nervus  Azygos.  It  distributes  numerous 
branches  to  the  neighbouring  parts,  and  to  the  nerves  as  they 
go  out,  and  enters  into  frequent  anastomoses  with  the  spi- 
nal branches,  penetrating  the  interstices  of  the  vertebrae. 

The  basilar  artery,  being  formed  as  above, 
occupies  the  depression  in  the  middle  of  the  tuber 
annulare,  and  at  its  anterior  part  divides  into  four 


* • 


51 


parallel  branches,  proceeding  from  the  trunk  at 
right  angles.  Of  these,  the  posterior  go  to  the 
cerebellum  ; and  the  two  anterior,  ramified  on  the 
cerebrum,  unite  with  the  communicating  arteries 
of  the  carotid,  and  form  the  Great  Circle  of  Willis. 

The  Deep  Arteries  of  ilie  Cerebellum — Right  and 
Left — winding  behind  the  crura  of  the  cerebrum  to  the 
superior  part  of  the  cerebellum,  and  there  exhibiting, 

The  Deep  Artery  of  the  Cerebrum — larger  than  the 
last,  and  separated  from  it  by  the  third  pair  of  nerves. 
Turns  upwards  along  with  the  former,  between  the  cere, 
bellum  and  posterior  lobe  of  the  cerebrum  ; and  gives, 

1.  Communicating  Branches — forming  the  circle  of 
Willis,  and  frequently  of  unequal  size.  They  proceed 
forwards, almost  at  a right  angle,  to  meet  the  communicating 
artery  of  the  carotid,  and  give  minute  twigs  to  the  adjacent 
parts. 

2.  A branch,  going  to  the  sides  of  the  crura  of  the 
cerebrum  and  the  lateral  ventricle,  and  distributing  small 
branches  above  the  thalami,  to  the  corpora  quadrigemina, 
the  pineal  gland,  the  choroid  plexus  covering  these  parts, 
to  the  fornix,  the  corpora  striata,  and  the  third  ventricle. 

3.  A branch,  the  greatest  part  of  which  is  sent,  imme- 
diately with  its  very  numerous  twigs,  into  the  sulci  of  the 
posterior  lobe ; from  which,  again,  smaller  ramifications 
arise,  to  be  distributed,  to  the  corpus  callosum  and  septum 
lucid  um. 

D.  The  INFERIOR  THYROID,  Or  ANTERIOR 
cervical  artery — rising  from  the  fore  part 
of  the  trunk,  near  the  mammary  and  vertebral  arte- 
ries ; and  being  covered  by  the  sternomastoid,  and 


52 


bent  a little  upwards  and  outwards,  immediately 
divides  into  four  principal  branches — 

1.  The  Transverse  Scapular — the  lowest  branch  of  the 
thyroid  artery,  but  sometimes  of  considerable  size — is 
covered  at  first  by  the  sternomastoid,  ?nd  passes  trans- 
versely to  the  scapula,  under  the  trapezius.  The  superfi- 
cial cervical  sometimes  supplies  the  place  of  its  superior 
scapular  branch. 

Branches  going  separately  to  the  sternomastoid,  the 
sternohyoid,  the  omohyoid,  and  the  subclavian  muscles,  the 
coats  of  the  arteries  and  reins,  and  the  skin  of  the  neck 
and  breast. 

The  Superficial  Scapular  Branch — giving  twigs  to  the 
integuments  on  the  top  of  the  shoulder  and  surface  of  the 
trapezius  and  deltoid. 

Branches  to  the  posterior  part  of  the  trapezius. 

Branches  to  the  levator  scapulas  and  the  serratus. 

Thus  is  the  artery  often  wholly  expended.  At  other 
times,  it  sinks  deep  under  the  trapezius,  in  many  tortuous 
windings,  where  it  properly  takes  the  name  of  superior 
scapula , or  clorsoscapuldr ; and  is  chiefly  divided  into  two 
smaller  trunks,  sending  previously  off 

Branches  to  the  subclavian  and  adjoining  part  of  the 
trapezius  muscle. 

Branches  to  the  lesser  portion  of  the  serratus  major 
anticus,  and  adjoining  rhomboid,  near  the  superior  angle 
of  the  scapula. 

A branch,  running  upon  the  surface  of  the  supraspina. 
tus  to  the  concave  side  of  the  acromion  ; inosculating, 
near  the  coracoid  process,  with  the  humeral  thoracic  of 
the  axilla,  and  again  communicating,  at  the  superior  angle, 
with  the  superficial  artery  of  the  base. 

A branch,  passing  over  the  outer  surface  of  the  spine 
of  the  scapula  ; and,  after  giving  twigs  to  the  bone  and 
the  neighbouring  muscles,  inosculating  with  the  inferior 
circumflex  scapular  in  the  infraspiual  cavity. 


53 


Under  the  Trapezius,  it  divides  into 

The  Super  spinal — the  first  branch  of  the  divided  artery, 
passing  through  the  semilunar  notch , and  distributing 
many  twigs  to  the  supraspinatus,  is  continued  onwards, 
in  two  branches,  under  the  acromion  process  and  supras- 
pinatus, where  it  begins  to  send  branches  to  the  scapula 
itself,  the  capsular  ligament,  the  infraspinatus,  the  teres 
minor,  and  at  last  inosculates  with  the  inferior  circumflex 
scapula. 

The  Superficial  Branch  of  the  base  of  the  Scapula-*- 
larger — proceeds  near  the  lower  part  of  the  levator  scapu- 
las to  the  base,  and,  going  down  between  the  serratus  major 
and  the  rhomboid,  reaches  the  inferior  angle  of  the  scapula. 
In  this  course,  it  gives  many  branches  to  the  rhomboid  and 
serratus ; and  through  them  to  the  trapezius,  the  serratus 
posterior,  the  skin,  and  subscapular  muscle : afterwards 
forms,  near  the  inferior  angle,  with  the  inferior  scapular 
branch,  a beautiful  circle  upon  the  surface  of  the  serratus: 
from  which  branches  descend  to  the  latissimus  dorsi. 

2-  The  Transverse  Cervical — running,  by  the  side  of 
the  neck,  transversely  and  upwards,  to  the  cervex,  where 
it  is  concealed  by  the  trapezius.  Its  various  branches 
sometimes  arise  from  the  superficial  cervical  artery. 

Branches  to  the  sternomastoid  and  skin. 

Branches  to  the  trapezius,  levator  scapulae,  and  sple- 
nius. 

A large  branch,  ascending  between  the  splenius  and 
trapezius,  giving  ramuli  to  both  these  and  the  complexus, 
and  at  last  inosculating  freely  amongst  the  muscles  with 
the  descending  branch  of  the  principal  occipito-cervical 
artery. 

A branch  descending  to  the  trapezius,  rhomboid,  com- 
plexus, and  supraspinatus  muscles, and  inosculating  with  the 
superficial  cervical  and  the  transverse  scapular  branches. 

3 The  Ascending  Thyroid  Artery  rising  between  the 
rectus  anterior  and  scaleni  muscles,  upon  the  fore-part  of 
the  transverse  processes,  as  high  as  the  second  vertebra  ; 


54 


varying  in  size  and  in  the  number  of  its  branches.  It 
sends, 

Deep  branches,  which  are  sunk  between  the  vertebral 
interstices  as  the  artery  ascends.  Of  these  are  reckoned, 

Branches  to  the  intertransversarii,  scaleni  postici,  and 
the  origin  of  the  splenii  muscles. 

Branches  passing  through  the  openings  for  the  inter- 
costal nerves  to  the  involucra  of  the  spinal  marrow,  and 
inosculating  with  twigs  of  the  vertebral  artery. 

4.  The  Thyroid  Branch  of  the  Thyroid  Artery In 

this  the  whole  is  expended.  It  bends  under  the  carotid  to 
the  side  of  the  larynx ; and,  after  repeated  windings, 
reaches  the  inferior  part  of  the  thyroid  gland.  It  sinks 
into  the  gland  : and  while  it  divides  into  many  ramifica- 
tions, is  partly  distributed  to  the  whole  gland,  and  partly 
inosculates  with  the  superior  thyroid. 

E.  The  deep,  or  posterior  cervical  ar- 
tery— Irregular  in  its  origin,  size,  and  extent, 
and,  like  the  superficial  cervical , or  transverse  sca- 
pular of  the  thyroid,  spreads,  sometimes  more,  and 
sometimes  less  extensively,  with  its  branches.  It 
is  sometimes  the  smallest  of  all,  and  proceeding 
from  the  superior  intercostal.  It  generally 
issues  from  the  subclavian,  beyond  the  margin  of 
the  scalenus,  though  sometimes  sooner  under  this 
muscle.  It  then  winds  upwards  and  backwards, 
between  the  deep  muscles  of  the  neck  and  the 
sixth  vertebra;  and  is  at  last  so  dispersed  among 
the  muscles,  as  to  bestow  its  ultimate  branches  on 
the  complexus,  near  the  occiput.  It  usually 
gives, 

Branches  winding  on  the  surface  of  the  bodies  of  the 
vertebrae. 


55 


Branches  distributed  to  the  scaleni  muscles. 

Branches  to  the  spinal  muscles  of  the  neck,  the  trache, 
lomastoid,  splenius,  and  intertransversalis. 

Branches  to  the  complexus,  often  interwoven  with  the 
occipital  branches. 

F.  The  superficial  cervical — rises  about 
half  an  inch,  or  an  inch  from  the  first  scalenus,  at 
the  upper  and  anterior  side  of  the  subclavian 
where  it  begins  to  bend  downwards ; immediately 
hides  itself  among  the  brachial  nerves ; and  spread- 
ing out  afterwards,  towards  the  superior  costa  of 
the  scapula,  divides  into  many  irregular  branches. 


DISTRIBUTION  OF  THE  AXILLARY  ARTERY. 

The  Subclavian  Artery,  as  it  bends  from 
its  first  situation,  between  the  breast  and  sca- 
pula, to  the  humerus,  assumes  the  name  of 
Axillary.  Passing  out  under  the  arch  of 
the  clavicle,  it  is  surrounded  by  the  nerves  of 
the  brachial  plexus,  the  veins,  glands,  and  a 
quantity  of  fat ; lies  in  the  hollow  of  the  ax- 
illa, between  the  subscapular  and  the  serratus 
major : and,  protected  externally  by  the  pec- 
toral muscles,  it  soon  approaches  forwards  to 
the  arm  and  the  interior  margin  of  the  biceps. 


56 


At  last  proceeding  from  the  axilla  to  the  in- 
ferior border  of  the  tendon  of  the  latissimus 
dorsi,  it  takes  the  name  of  Humeral  artery. 
It  sends  off, 

A.  Small  Branches  to  the  scalenus,  first 
rib,  coracoid  process,  the  adjacent  muscles  and 
nerves. 

B.  The  highest  thoracic  branch — aris- 
ing above  the  second  rib  or  at  the  inferior  margin 
of  the  first,  and  distributed  in  the  upper  region  of 
the  thorax,  between  the  serratus  and  small  pecto- 
ral— 

C.  The  long,  or  superior  thoracic,  or 
external  mammary — running  down  as  far 
as  the  fifth  costal  interstice.  It  sometimes  arises 
from  the  circumflex,  or  from  inferior  scapular. 

Branches  to  the  glands  of  the  asilla  and  mamma,  run. 
ning  sometimes  to  the  nipple. 

Many  branches,  irregular  in  series  and  situation,  to  the 
serratus  major  and  minor;  and,  passing  the  second  and 
fourth  interstices,  to  the  great  pectoral  and  mamma,  anas- 
tomosing  with  the  highest  thoracic. 

Branches,  sinking  deeper,  forming  double  circles  with 
the  internal  mammary  and  the  inferior  intercostal , as  low 
as  the  interstice  of  the  fifth  rib,  and  sending  branches  to 
the  intercostal  muscles. 

D.  The  Humeral  thoracic — rising  from 
die  anterior  part  of  the  trunk,  between  the  second 
rib  and  the  coracoid  process,  to  the  upper  margin 
of  the  lesser  pectoral ; penetrates  the  interstice  of 


57 


the  deltoid  and  pectoral  muscles ; and  in  its  course 
sends 

A deep  branch  to  the  serratus  major. 

Branches  to  the  deltoid,  to  the  great  pectoral  and  sub- 
clavian muscles,  and  rising,  above  the  clavicle,  to  the 
neck. 

A branch,  running  along  the  subclavian  muscle  to  the 
pectoral;  and,  in  the  space  between  this  and  the  deltoid, 
distributing  its  branch  to  the  pectoral  muscle,  the  clavicle, 
and  skin,  and  at  last  inosculating  with  the  transverse  sea - 
pular. 

E.  The  alar  thoracic — This  artery  some- 
times wanting,  though  at  other  times  it  is  large, 
and  sends  numerous  branches  to  the  axillary  gland, 
and  some  also,  spreading  extensively  in  various 
directions,  to  the  subscapular,  pectoral,  and  ser- 
ratus. 

F.  T wo  or  more  large  branches,  rising  near  the 
upper  and  inferior  margin  of  the  scapula,  sending 
twigs  to  the  nerves,  serratus,  levator  scapulae,  la- 
tissimus  dorsi,  and  particularly  the  subscapular ; 
inosculating,  partly  with  the  superficial  thyroid 
scapular  of  the  base,  and  partly  disappearing  among 
the  muscles. 

G.  The  inferior  scapular,  or  infrasca- 
pular, or  subscapular — rising  at  the  infe- 
rior margin  of  the  subscapular  muscle,  divides 
into  conspicuous  branches,  which  run  in  various 
directions.  Arises,  also,  sometimes  among  the 
thoracic  branches,  when,  bending  downwards,  it 
sends 


7 


58 


A branch  to  the  surface  of  the  subscapular,  the  capsu- 
lar ligament,  and  the  muscles  attached  to  the  coracoid  pro- 
cess. 

A Deep  Branch — winding,  with  its  twigs,  through  the 
subscapular  to  the  naked  scapula,  fter  giving  twigs  toth« 
teres  major  and  ialissimus  dorsi. 

A Muscular  Branch — large  md  sometimes  rising  sepa- 
rately. Sending  branches  to  the  subscapular,  extending 
as  far  as  the  base  of  the  scapula  ; and  distributing  exten- 
sively large  branches  to  the  teres  major,  the  serratus,  the 
latissime-s  dorsi,  and  axillary  glands. 

A Conspicuous  Branch — running  closely  along  the  mar- 
gin of  the  subscapular,  and  forming,  at  the  inferior  angle 
of  the  scapula  which  it  traverses,  a large  circle  w ith  the 
superficial  thyroid  scapular  of  the  base.  It  rises  some- 
times from  the  muscular  branch. 

A branch,  parallel  to  the  inferior  costa,  and  extending 
to  the  teres,  the  long  extensor  and  the  glands. 

The  Scapular  Circumflex. — The  branches  al- 
ready enumerated  having  supplied  the  inner  part 
of  the  scapula,  this  large  trunk  bends  between  the 
r inferior  costa  of  the  scapula  and  teres  major,  to 
the  infraspinal  cavity,  near  the  cervix,  and  pro- 
ceeds under  the  teres  minor  and  infraspinatus  to 
the  spine ; giving 

H.  The  posterior  circumflex  artery — 
issuing  between  the  subscapular  and  teres  major  ; 
it  sinks  between  them,  winds  rounds  the  neck  of 
the  humerus,  under  the  long  extensor,  and  after- 
wards bends  transversely,  under  the  deltoid,  back- 
wards and  outwards,  from  the  inner  side  of  the 
arm.  It  sometimes  gives  rise  to  the  anterior  cir- 
cumflex, and  the  deep  branch  of  the  humerus,  or 
humeral  profunda  ; and  sends 


59 


A branch  to  the  capsule  ami  the  circumflex  nerve,  which 
it  accompanies. 

A branch  to  the  coracobrachial,  internal  triceps,  and  - 
the  teres  minor. 

A branch,  variously  ramified  on  the  capsule,  the  anco- 
neus, and  periosteum ; anastomosing  freely  with  branches 
from  the  subscapular,  and  running  transversely,  in  a cir- 
cular course,  to  the  deltoid. 

I.  The  ANTERIOR  CIRCUMFLEX  ARTERY 

of  smaller  size — sent  out  near  the  former,  above 
the  teres  major,  proceeds  round  the  humerus,  un- 
der the  biceps  and  coracobrachial,  to  the  outer 
part  of  the  arm,  where  it  either  disappears  under 
the  deltoid,  or  enters  this  muscle  ; and  sends 

Many  branches  to  the  subscapular,  the  latissimus  dorsi, 
and  the  long  extensor.  They  are  often  wanting. 

Branches  to  the  biceps,  capsule,  coracobrochial,  and 
deltoid. 

A branch,  sunk  in  the  bicipital  groove;  and,  at  the  cap- 
sular ligament,  inosculating  by  an  ascending  twig,  with 
the  superior  branches  of  the  posterior  circumflex , and  by 
a descending  twig,  with  the  deep  branch  of  the  humeral 
profunda , in  the  bicipital  groove. 


DISTRIBUTION  OE  THE  BRACHIAL  OR  HUMERAL  ARTERY. 

The  Axillary  Artery  is  first  known  by 
the  name  of  Humeral  or  Brachial,  where 
it  proceeds  from  the  axilla  to  the  internal  side 
of  the  arm.  Having  left  the  cavity  of  the  ax- 
illa, and  passed  to  the  internal  surface  of  the 


60 


tendon  of  the  teres  major,  it  continues-  its 
course  above  the  internal  brachial  to  the  inner 
side  of  the  biceps,  and  gradually  runs  along 
the  middle  of  the  arm  to  the  anterior  surface 
of  its  extremity;  where  at  last,  concealed  un- 
der the  aponeurosis  of  the  biceps,  it  divides, 
near  the  bend  of  the  fore-arm,  into  Ulnar 
and  Radial  Arteries. 

A.  A branch — going  down,  near  the  tendon 
of  the  teres  major,  under  the  coracobrachial,  to 
the  bicipital  groove  and  giving  recurrent  twigs  to 
the  head  of  the  humerus  and  capsule. 

B.  Branches  to  the  head  of  triceps  and  cora- 
cobrachial. 

C.  Many  branches  going  out,  in  various 
places  to  the  biceps,  the  internal  brachial,  and 
bone. 

D.  The  deep  branch  of  the  humerus,  the 
large  collateral,  or  large  humeral  pro- 
funda— sometimes  double  rising,  from  the  inner 
side  of  the  trunk,  at  the  inferior  margin  of  the 
teres  major ; but  sometimes  sooner,  from  the  infe- 
rior scapular , or  posterior  circumfex.  It  pro- 
ceeds backwards,  with  a gentle  curve  ; and,  ac- 
companying the  long  extensor,  runs  to  the  cavity 
between  the  anconei  muscles,  where,  in  the  pas- 
sage of  the  spiral  nerve,  it  divides  into  two 
branches,  at  the  upper  junction  of  the  external 
anconeus  and  internal  brachial.  It  gives 


61 


A branch  to  the  long  and  external  head  of  triceps. 

A branch  to  the  biceps,  coracobrachial,  the  periosteum, 
the  tendon  of  the  teres  major,  and  the  deltoid;  inosculat- 
ing with  twigs  of  the  anterior  circumflex,  and  with  other 
branches  of  the  humeral  artery. 

Many  distinct  branches,  sent  off  from  the  trunk  in  its 
descent ; some  of  them  ascending  to  inosculate  with  branches 
of  the  humeral  and  scapural  arteries,  and  others  descend- 
ing to  be  ramified  on  the  muscles. 

The  Large  Communicating  Radial , or  Profun- 
da-radial — The  internal  branch  of  the  divided 
trunk,  which  winding  between  the  external  head 
to  the  spine  of  the  condyle,  forms,  around  the  ex- 
ternal or  extensor  cond\le,  anastomotic  arches 
with  the  radial  recurrent,  the  lesser  profunda , and 
superior  interosseal perforant . 

The  Large  Communicating  Ulnar , or  Profunda- 
ulnar — the  interior  and  deeper  branch  of  the  divid- 
ed trunk,  bending  between  the  internal  anconeus 
and  brachial,  to  the  internal  or  fexor  condyle; 
and  sending 

E.  A branch  to  the  coracobrachial  and  inter- 
nal brachial. 

F.  A branch — descending  on  the  surface  of 
the  internal  anconeus,  and  communicating,  near 
the  bend  of  the  elbow,  with  the  ulnar  recurrent , 
the  great  anastomotic , or  sometimes  with  both. 

G.  A branch — which,  after  having  sent  off 
twigs  to  the  adjoining  anconei  and  coracobrachial 
muscles,  proceeds  upon  the  inner  surface  of  the 
arm,  as  far  as  the  olecranon,  and  inosculates  with 
branches  of  the  Ulnar  recurrent  and  dorsal  arch. 


62 


H.  Branches  ramified  on  the  biceps  and  cora- 
cobrachial, irregular  both  in  number  and  origin, 
and  distributing  their  twigs  both  upwards  and 
downwards. 

I.  The  LARGE  NUTRITIOUS  ARTERY  of  the 
humerus — arising  at  the  inferior  part  of  the  cora- 
cobrachial, bending  outwards,  and  sending  off 

A branch  to  the  external  anconeus  and  skin  ; inosculat- 
ing with  the  other  branches  distributed  to  that  muscle. 

A deep  branch  to  the  internal  brachial,  at  last  termi- 
nating in  the  deltoid. 

Branches  entering  the  bone  in  several  places. 

Branches,  inosculating,  at  times,  with  the  large  anos. 
tomolic  or  lesser  profunda. 

K.  The  lesser  profunda — rising  externally 
from  the  trunk  ; penetrating  the  internal  brachial, 
and  winding  between  the  supinator  and  the  radial 
extensor,  to  the  outer  or  extensor  condyle.  By 
its  ascending  twigs,  it  inosculates  with  the  nutri- 
tious, and  by  its  descending,  with  the  radial  recur- 
rent. These  likewise  pass  sometimes  to  the  arti- 
cular ligaments. 

L.  The  large  anostomotic — rising,  some- 
times double,  from  the  internal  side  of  the  trunk, 
a few  inches  above  the  joint ; but  immediately  di- 
viding, it  passes,  in  a transverse  course,  upon  the 
surface  of  the  internal  brachial,  to  the  flexor  con- 
dyle, where,  perforating  the  intermuscular  liga- 
ment, it  runs  upwards  to  the  cavity,  between  the 
condyle  and  olecranon,  covered  by  the  tendon  of 
the  triceps  and  the  ulnar  flexor  of  the  carpus.  It 
sends  off 


63 


•An  Ascending  Branch — sinking  in  the  anconeus,  and 
anastomosihg  with  the  large  communicating  ulnar. 

A Descending  Superficial  Branch — to  the  pronator, 
sublimis,  and  internal  brachial.  It  inosculates  with  su- 
perficial twigs  of  the  ulnar  recurrent ; and,  after  perforat- 
ing the  muscle,  again  anastomoses,  upon  the  periosteum 
and  capsule  of  the  fore-arm,  with  branches  of  the  radial 
recurrent , where  it  forms,  around  the  articulation,  the 
anterior  arch. 

A Deep  Descending  Branch,  anastomosing,  anteriorly, 
with  the  ulnar  recurrent , and  posteriorly  with  the  same 
recurrent  and  interosseal  artery. 

A Transverse  Branch — which,  with  theprofunda-ulnar , 
the  profunda.radial , the  lesser  profunda,  and  all  the 
recurrents  forms,  above  and  below  the  condyle,  the 
posterior  dorsal  arch  of  the  humerus.  This  arch  distri- 
butes many  branches  to  the  joint,  and  the  neighbouring 
parts. 


THE  EiiVAR  ARTERY. 

The  humeral  artery  sometimes  undergoes 
the  division  already  mentioned  at  the  middle 
of  the  humerus,  or  even  higher.  This,  how- 
ever, is  the  largest  artery  which  arises  from 
the  trunk  at  the  bend  of  the  arm.  Scarcely 
has  it  arisen,  when  it  sinks  deep  into  the 
cavity  that  is  occupied  by  the  tendon  of  the 
biceps,  the  nerve,  blood-vessels,  and  fat.  It 
then  bends,  near  the  interstice  of  the  bones? 


64 


under  the  pronator  teres,  radial  flexor,  palma- 
ris  longus,  and  sublimis,  to  the  ulnar  side  of 
the  fore-arm,  proceeding  gradually,  with  many 
deflections,  between  the  sublimis,  the  profun- 
dus, and  ulnar  flexor,  to  the  wrist.  Passing 
over  the  wrist,  it  forms  the  superficial  arch  of 
the  hand,  which  gives  beautiful  arteries  to  the 
fingers,  and  finally  inosculates  at  the  palm 
with  the  radial  artery.  The  more  remarka- 
ble branches  which  it  sends  off"  are, 

A.  A branch  to  the  pronator  teres  and  the 
common  head  of  the  flexors. 

B.  The  HIGHEST  INTEROSSEAL  PERFORANT 

going  first  to  the  internal  brachial  and  capsule, 
where  it  forms  the  anterior  arch , by  a branch  in- 
osculating with  the  anastomotic  and  the  radial  and 
ulnar  recurrents.  After  perforating  the  interstice 
of  the  bones,  it  sends,  under  the  small  anconeus, 
a number  of  recurrent  branches  upwards  to  the 
dorsal  arch , and  downwards  to  the  extensor  mus- 
cles. The  whole  artery  often  rises  from  the  com- 
mon interosseal. 

C.  The  ulnar  recurrent — sent  oft'  from  the 
ulnar  side  of  the  trunk,  a little  above  the  common 
interosseal ; and,  having  passed  through  the  flexor 
muscles,  is  reflected  to  the  posterior  part  of  the 
internal  condyle.  In  which  course  are  distribut- 
ed. 


65 


A branch  to  the  capsule,  the  flexor  muscles,  and  ulna. 

D.  The  nutritious  artery  of  the  ulna  — 
running  on  the  anterior  surface  of  the  bone,  near 
the  origin  of  the  profundus. 

E.  The  COMMON  INTEROSSEAL rising  at 

the  higher  extremity  of  the  profundus — running 
on  the  interosseous  ligament,  between  the  flexor 
pollicis  and  profundus,  to  the  pronator  quadratus, 
and  there  dividing  into  two  arteries, 

Branches  to  the  radial  flexor  of  the  carpus  pronator  ro- 
tundus,  profundus,  and  sublimis. 

A small  Perforant  Branch — to  the  supinator  brevis  and 
capsule. 

A branch  to  the  flexor  of  the  thumb  and  tendon  of  the 
biceps. 

A Nutritious  Branch  of  the  Ulna — entering  the  middle 
surface  of  this  bone. 

The  Highest  Posterior  Interosseal  Perforant 
— rising,  sometimes  wholly,  from  the  ulnar,  some- 
times double,  when  its  largest  division  communi- 
cates, by  its  recurrent  twigs,  with  the  former  ; but 
sends  off  at  the  same  time,  a large  descending 
branch,  running  with  the  extensor  of  the  little  fin- 
ger, by  which  it  is  covered,  as  far  as  the  extremi- 
ty of  the  fore-arm,  where  at  last  in  inosculates  with 
the  posterior  dor  so  interosseal.  It  gives 

} 

Reflex  branches  to  the  supinator  brevis  and  the  origin 
of  the  common  extensor. 

8 


66 


Branches  ramified  on  the  radial  and  ulnar  extensors  of 
the  carpus. 

Branches  to  the  extensors  of  the  thumb,  the  common 
extensor,  and  abductor. 

A large  branch  to  the  profundus,  winding  extensively 
downwards  on  this  muscle. 

The  Nutritious  Artery  of  the  Radius . 

Many  branches — going  in  the  descent  of  the  trunk,  to 
the  profundus  and  the  flexor  of  the  thumb. 

Small  Interosseal  P erf  or  ants — from  four  to  seven  in 
number  ; rising  separately  from  the  trunk ; perforating, 
in  different  places,  the  interosseous  ligament ; and  passing 
into  the  common  extensor,  supinator  brevis,  ulnar  exten- 
sor of  the  carpus,  the  extensors  of  the  thumb,  fore  finger, 
little  finger,  and  periosteum,  they  all  enter  into  various 
inosculations  with  one  another ; and  the  superior  are 
larger  than  the  inferior, 

The  Posterior  Dorso.Interosseal — the  larger  branch  of 
the  divided  artery  ; rising  at  the  inferior  margin  of  the 
pronator  quadratus  ; and,  having  passed  over  the  interos- 
seous space,  branching  out  at  the  posterior  extremity  of  the 
ulna  and  wrist,  divides  into  three  branches. 

A branch,  anastomosing  with  the  highest  interosseal 
perforant. 

The  Ulnar  Branch — the  first  artery  of  the  divided 
trunk,  bending  to  the  posterior  surface  of  the  ulna,  along 
with  the  tendon  of  the  ulna  extensor ; and  inosculating 
with  the  perforating  branches  of  the  radial  artery,  the 
middle  branch  and  the  dorsal  of  the  hand. 

The  Middle  Branch,  larger  than  the  rest;  sinking  under 
the  ligament  of  the  carpus  to  the  tendons,  the  ligaments, 
and  skin;  forming  a plexus  with  the  perforating  branches, 
the  dorsa  carpal , and  its  fellows. 

The  Radial  Branch,  accompanying  the  second  tendon 
of  the  radial  extensor,  and  inosculating  with  the  preceding 
twig  under  the  ligaments,  as  also  with  the  first  metacarpal 
branch  of  the  dorso.carpal , and  the  radial  perforants’ 


67 


These  three,  in  conjunction  with  the  dorso-carpal  and 
dorsal  of  the  hand , form  a beautiful  plexus  around  the 
carpus. 

The  Vola.interosseal — the  other  branch  of  the  trunk 
covered  by  the  pronator,  running  to  the  naked  ligaments 
of  the  carpus,  where,  after  supplying  with  many  twigs  the 
ulna,  radius,  and  the  articulation  of  the  wrist,  it  forms  a 
vascular  plexus  with  the  recurrent  branches  of  the  deep 
volar  arch.  In  this  course  it  forms  other  minute  inoscula- 
tions with  the  radial  and  ulnar. 

F.  Many  branches — rising  from  the  de- 
scending trunk  ; irregular  in  number  and  situation, 
and  going  to  the  long  flexor  of  the  thumb,  the 
radial  nerve,  the  radial  and  ulnar  flexors,  the  palma- 
ris,  sublimis,  profundus,  and  skin. 

G.  The  dorsal  of  the  hand — rising  at  the 
lower  side  of  the  ulna,  near  the  pronator  quadra- 
tus,  at  the  distance  of  an  inch  from  the  pisiform 
bone  ; winding  under  the  ulnar  flexor,  to  the  back 
of  the  hand,  and  proceeding  to  the  ulnar  side  of  the 
little  finger.  From  this  are  sent 

A branch  to  the  pronator  quadratus,  inosculating  with 
a twig  of  the  radial. 

The  Dorso-ulnar  of  the  Little  Finger — terminating  in 
the  first  phalanx,  as  it  unites  with  the  volar  branch  of  the 
same  finger.  It  is  often,  however,  expended  much  sooner 
about  the  carpus. 

H.  A branch,  distributed  extensively  above 
these  to  the  flexor  tendons. 

I.  Branches  to  the  pisiform  bone,  the  palma- 
ris  brevis,  and  the  internal  ligament  of  the  carpus. 


68 


These  rise  from  the  trunk,  as  it  proceeds  between 
the  pisiform  bone,  and  the  carpal  ligament  to  the 
hand. 

K.  Branches  to  the  abductor  of  the  little 
finger,  its  flexor,  abductor,  and  palmaris  brevis, 
communicating  with  the  dorso-ulnar  of  the  same 
finger. 

L.  The  ULNAR  PROFUNDA,  Or  DEEP  ULNAR 
branch  of  the  hand — rising  at  the  inferior  mar- 
gin of  the  carpal  ligament ; concealed  between  the 
abductor  and  flexor  of  the  little  finger  ; and,  pro- 
ceeding to  the  deep  volar  arch,  gives 

Branches  to  the  skiD,  palmaris  brevis,  and  adjacent 
muscles. 

A Deep  Circumflex  Branch — uniting  with  the  radial 
artery,  and  forming,  under  the  tendons,  the  deep  volar 
arch.  Even  when  double,  it  exhibits  a continuation  of 
the  trunk,  and  supports  a communication  between  the  two 
arches. 

M.  The  vola-ulnar  of  the  little  finger 
— rising  near  the  former,  and,  having  distributed 
branches  to  the  metacarpal,  adductor,  abductor, 
and  the  fourth  lumbrical,  and  others  communi- 
cating with  the  ulnar  profunda  and  the  fifth  interior 
volar  perforant , runs  to  the  other  extremity  of 
the  fifth  metacarpal  bone,  where  it  inosculates 
with  the  dorso-ulnar  of  the  little  finger. 

N.  The  first  vol a- digital — rising  near  the 
fifth  finger,  from  the  trunk  as  it  bends  transversely 
above  the  flexor  tendons,  where  the  superficial  arch 
is  formed,  divides,  at  the  root  of  the  fingers,  into 


69 


the  digito-radial  of  the  little  finger,  and  the  digito- 
ulncir  of  the  ring  finger.  Each  of  these  runs  tor- 
tuously along  the  sides  of  the  fingers,  as  far  as 
the  apex.  This  digital  likewise  gives 

Branches  to  the  third  and  fourth  lumbricals,  and  the 
tendons  of  the  flexors. 

A branch,  forming  a small  arch  upon  the  points  of  the 
fingers  with  the  volar  artery  of  the  opposite  side. 

O.  The  second  vola-digital — divided 
into  the  digito-radial  of  the  ring  finger,  and  the 
digito-idnar  of  the  middle  finger.  From  this  pro- 
ceed, 

P.  The  third  vola-digital — divided  into 
the  digito-radial  of  the  middle,  and  the  digito-idnar 
of  the  fore  finger.  The  last  of  which  inosculates, 
on  the  concave  surface,  with  the  digito-radial  of 
the  fore-finger.  It  gives 

Branches  to  the  first  and  second  lumbricals. 

Branches  inosculating  with  the  deep  arch  and  its  perfo. 
rants. 

Q.  Br  anches  to  the  first  lumbricals,  the 
abductor,  adductor,  and  flexor  of  the  thumb,  the 
tendons  of  the  flexors  and  the  skin. 

R.  A LARGE  ANASTOMOTIC  BRANCH Unit- 

ing with  the  radial  artery,  near  the  superior  margin 
of  the  adductor  of  the  thumb.  From  this  inoscu- 
lation a trunk  is  formed,  which  gives  out  the  vola- 
radial  of  the  fore  finger,  and  the  vola-ulnar  of  the 
thumb,  or  sometimes  the  vola-ulnar  only. 


70 


S.  Many  minute  branches — issuing  from 
the  concave  surface  of  the  arch,  and  ramified  upon 
the  tendons ; afterwards  sinking  deeper  to  the 
wrist,  inosculating  with  many  twigs  of  the  vola 
interosseal. 

THE  RADIAL  ARTERY. 

The  smallest  of  the  two  branches  which 
proceed  from  the  division  of  the  humeral.  It 
runs  down  in  a straight  line,  upon  the  surface 
of  the  pronator  and  gradually  inclines  towards 
the  radius,  between  the  long  supinator  and 
radial  flexor,  resting  on  the  flexor  of  the  thumb. 
At  the  lower  extremity  of  the  radius,  where  it 
is  easily  felt  between  the  styliform  process 
and  the  trapezium,  on  the  back  of  the  hand,  it 
bends  under  the  abductor  and  extensor  of  the 
thumb,  near  the  first  radial  extensor ; then 
penetrating  the  abductor  or  semi-interosseous 
of  the  fore  finger,  between  the  metacarpal  bone 
of  the  fore  finger  and  thumb,  bends  while 
there  concealed,  to  the  palm,  between  the 
fibres  of  the  adductor  pollicis  and  forms,  in  the 
hollow  of  the  hand,  under  the  flexors,  and 
above  the  interosseous  muscles,  the  deep  volar 
arch,  in  which  it  terminates. 


71 


A.  A branch,  dividing  upwards  and  down- 
wards  to  the  supinator  longus  and  the  radial 
extensors,  sometimes  inosculating  with  the  small 
humeral  profunda. 

B.  The  radial  recurrent — reflected  round 
the  tendon  of  the  biceps,  to  the  external  condyle; 
concealed  between  the  long  supinator,  the  short 
radial  extensor  and  internal  brachial,  where  it 
forms,  like  the  ulnar  recurrent , important  inoscu- 
lations, and  gives 

Branches  to  the  pronator  rotundus,  short  supinator,  and 
radial  extensors ; which,  in  their  descent,  inosculate  with 
other  recurrent  ramuli. 

Branches  proceeding,  at  various  places  from  the  trunk 
to  the  radial  extensors  long  supinator,  the  extensors  of 
the  fingers,  the  ulnar  extensor,  and  skin.  Of  these,  the 
branches  reflected  to  the  extensors  inosculate  with  the 
highest  posterior  interosseal  perforant. 

The  Superficial  Anostomotic  Branch — inosculating  on 
the  surface  of  the  internal  brachial  with  the  small  hume- 
ral profunda,  and  the  prof  unda-radial  of  the  arm,  as  they 
wind  near  the  spine  of  the  condyle,  under  the  superior 
fleshy  part  of  the  supinator  and  the  radial  extensor. 

A branch  sunk  in  the  internal  brachial,  and  forming, 
round  the  joint  on  the  capsule  and  pereosteum,  the  ante- 
rior arch  with  the  large  anostomotic  branch  of  the  hume- 
ral. 

The  Deep  Anastomotic  Brauch — running  extensively  be- 
tween the  long  supinator  and  the  bone,  or  betwixt  the  ra- 
dial extensor  and  triceps,  to  the  posterior  surface  of  the 
external  condyle,  where  it  inosculates  with  a branch  of 
the  small  profunda  and  the  prof unda-radial  of  the  arm. 

C.  Many  branches— as  the  trunk  runs 


72 


superficially  on  the  pronator  rotundus  to  the  radial 
extensors,  the  supinators,  the  pronator  rotundus, 
and  radial  flexor.  Some  of  these  usually  inoscu- 
late with  twigs  of  the  common  interosseal. 

D.  Branches — rising  from  the  artery  as  it 
leans  on  the  radius,  sinking  into  the  sublimis, 
flexor  of  the  thumb,  radial  flex  r,  and  palmaris 
longus,  and  in  many  places  inosculating  with 
branches  of  the  ulnar , going  to  the  same  muscles. 

E.  A BR  anch  to  the  pronator  quadratus,  inos- 
culating with  twigs  of  the  vola-interosseal. 

F.  Branches  to  the  tendons  of  the  supinator, 
radial,  abductor  of  the  thumb,  and  bone  of  the 
radius  ; uniting  with  the  dorso-interosseal. 

G.  Branches  running  on  the  hand  to  the  ten- 
dons of  the  flexors. 

H.  The  superficial  volar — rising  at  the 
inferior  extremity  of  the  radius,  where  the  trunk 
begins  to  bend  to  the  back  of  the  hand,  and  pro- 
ceeding, near  tht  os  trapezium,  beyond  the  ten- 
don of  the  radial  flexor,  runs  to  the  palm,  under 
the  skin,  and  above  the  short  abductor  of  the 
thumb.  This  artery  is  sometimes  large,  and  pre- 
sents many  varieties ; and,  at  other  times  is  so 
small  as  not  to  pass  the  abductor.  If  large,  it 
commonly  sends 

A branch,  inosculating  with  the  dorso  radial  of  the 
thumb. 

An  Anastomotic  Branch — uniting  with  the  ulnar  artery, 
near  the  termination  of  the  flexor  of  the  thumb,  to  which 
it  gives  twigs.  It  is  sometimes  wanting. 

The  Vola-ulnar  of  the  Thumb — rising  sometimes  from 


/ 


73 


the  trunk  (as  below);  at  other  times  exhibiting,  beyond 
the  abductor,  a continuation  of  the  trunk  on  the  ulnar 
side  of  the  thumb,  where  it  inosculates,  near  the  apex 
and  articulation,  w ith  the  vola-radial. 

I.  A branch — ramified  on  the  ligament  of  the 
carpus,  the  bone  of  the  radius,  and  flexor  tendons. 

K.  Br  anches  to  the  tendons  of  the  abductor, 
and  radials,  inosculating  with  the  dorso-radial  of 
the  fore  finger. 

L.  Branches  to  the  neighbouring  bones  and 
their  articulations. 

M.  A branch  to  the  abductor  brevis,  and  op- 
ponens  pollicis. 

N.  The  dorso-radial  of  the  thumb — rises 
from  the  trunk  as  it  bends  to  the  back  of  the  hand, 
near  the  os  trapezium,  and  accompanies  the  meta- 
carpal bone  of  the  thumb,  running  along  the  ex- 
ternal insertion  of  the  opponens. 

Branches  to  the  tendons  of  the  extensors,  abductor,  and 
opponens  of  the  thumb,  forming  in  many  places  above  its 
metacarpal  joint,  a vascular  arch  with  the  pollica r,  or 
principal  artery  of  the  thumb. 

A branch — uniting  at  the  last  phalanx  of  the  thumb 
with  the  vola-radial. 

O.  The  dorso-ulnar  of  the  thumb — rising 
near  the  os  trapezoides,  under  the  tendons  of  the 
abductor  and  long  extensor. 

Branches  to  the  abductor  and  articulation  of  the  fore 
finger  or  index,  inosculatinglvith  the  dorso-radial  of  the 
index. 

A branch  terminating  in  the  first  phalanx  of  the  thumb, 
and  inosculating  with  the  vola.ulnar  and  the  dorso-radial. 

9 


74 


P.  The  dorso  carpal — issues  from  the 
trunk,  near  the  tendons  of  the  radial,  and  proceeds 
transversely  above  the  carpus,  and  under  the  ten- 
dons of  the  extensors,  to  the  ulnar  side  of  the 
wrist,  where  it  forms  an  extensive  plexus  with  the 
branches  of  the  dorso-interosseal,  and  completes 
the  dorso-carpal  arch  with  the  dorsal  of  the  hand. 
At  the  same  time  sends  off 

The  First  Metacarpal  or  Dorso-interosseal — descend- 
ing beyond  the  carpus,  upon  the  surface  of  the  first  inter- 
osseous muscle,  between  the  fore  and  middle  fingers  ; and 
inosculates  with  the  third  vola-digital  at  its  bifurcation. 

Branches  to  the  bones  of  the  carpus  and  joint,  inoscu- 
lating with  the  branches  of  the  dorso-interosseal. 

The  Second  Metacarpal , Dorso-interosseal—  running 
in  the  interosseous  space  to  the  roots  of  the  third  and 
fourth  fingers. 

The  Third  Metacarpal , or  Dorso-interosseal — running, 
like  the  last,  in  the  fourth  interval  of  the  fingers,  and 
forming  similar  inosculations  with  the  adjoining  arteries. 
Sometimes  one  or  other  of  the  metacarpals  is  produced 
from  th e perfora?its. 

Q.  The  DORSO-RADIAL,  or  LARGE,  Or  RA- 
DIAL interosseal  of  the  index — rising  be- 
tween the  first  and  second  metacarpal  bones,  while 
the  trunk  penetrates  the  inferior  margin  of  the 
abductor  or  semi- interosseous  ; and,  following  the 
course  of  the  interosseous,  inosculates  on  the 
index  with  the  volar  artery  of  the  same  finger. 

R.  The  pollicar,  or  principal  artery  of 
the  thumb — rising  from  the  radial  trunk,  where 
it  sinks  among  the  muscles  to  the  palm  of  the 


75 


hand  between  two  metacarpal  bones ; and,  dividing 
into  two  branches,  runs  to  the  volar  side  of  the 
thumb,  between  its  abductor  and  adductor 
muscles.  It  generally  gives 

Many  branches  to  the  back  of  the  metacarpal  bone  and 
abductor  of  the  thumb. 

The  Digito,  or  Vola-radial  of  the  Index — running  to 
the  radial  side  of  the  fore-finger,  and  uniting,  beyoud  the 
adductor  of  the  thumb,  with  the  interosseal  of  the  index, 
ora  superficial  branch  of  the  ulnar. 

The  Digito , or  Volci-radial  of  the  Thumb — the  outer 
branch  of  the  trunk,  as  it  divides  at  the  lower  extremity 
of  the  metacarpus,  sends  many  twigs  to  the  back  of  the 
thumb  from  its  radial  side,  and  inosculates  upon  its  apex 
with 

The  Digito , or  V ola-ulnar  of  the  Thumb — the  internal 
branch  of  the  same  trunk,  rising  often  from  the  superficial 
vola-radial , reaching  to  the  thumb,  and  inosculating  with 
the  superficial  arch. 

S.  The  SUPERIOR  VOLAR  PERFORANTS 

three  in  number,  proceeding  from  the  concave 
margin  of  the  deep  volar  arch  as  it  rests  on  the 
interosseous  muscles;  and,  penetrating  near  the 
superior  extremity  of  the  metacarpal  bones,  at  the 
back  of  the  hand,  they  produce,  as  it  were,  middle 
metacarpals , interwoven  with  the  branches  of  the 
dorso-carpal. 

T.  The  INFERIOR  VOLAR  PERFORANTS,  OF 
volar  interosseals — rising  six  or  seven  in 
number,  from  the  convex  margin  of  the  deep 
arch.  They  occupy  the  metacarpal  interstices; 


76 


and,  winding  round  the  radial  and  ulnar  sides  of 
each  bone,  inosculate,  at  the  roots  of  the  fingers, 
with  the  metacarpal  and  vola-digital  branches. 

U.  TWO  OR  THREE  RECURRENT  BRANCHES 

to  the  carpus,  anastomosing  with  ramuli  of.  the 
vola-interosseal,  and  with  some  twigs  of  the  radial 
and  ulnar. 

V.  A branch,  completing  the  deep  arch , by 
inosculating  near  the  little  finger,  with  the  ulnar 
profunda  of  the  hand, 

III.  ARTERIES  from  the  thoracic  aorta. 

Through  its  whole  descent,  the  thoracic 
aorta  inclines  to  the  left;  though  near  the 
lesser  or  inferior  diaphragm  it  seems  gradu- 
ally to  approach  the  middle  of  the  vertebrae. 
The  numerous  branches  which  it  sends  out, 
though  not  large,  are  yet  worthy  of  notice. 
These  are 

I.  The  superior  and  posterior  pericar- 
diac artery — rising  from  the  concave  surface 
of  the  arch;  most  commonly,  however,  from  the 
subclavian  or  internal  mammary — which  see. 

II.  The  COMMON  BRONCHIAL  ARTERY 

rising  from  the  fore  part  of  the  thoracic  aorta,  and 
immediately  divided  into  the  right  and  left  bron- 
chial arteries.  Both  of  these,  as  they  go  down 


77 


the  anterior  part  of  the  trachea,  are  ramified  on 
the  bronchi,  their  glands,  and  vessels : the  left  on 
the  posterior  surface  of  the  lungs  ; and  the  right 
on  the  oesophagus  also.  Sometimes  this  artery  is 
wholly  wanting,  or  supplies  the  functions  of  the 
following  arteries. 

III.  The  RIGHT  BRONCHIAL  ARTERY rising 

sometimes  from  the  aorta;  at  other  times  from  the 
superior , of  the  inferior  intercostals ; sending  its 
twigs  both  before  and  behind  the  right  bronchus, 
to  the  air-vessels,  and  adjoining  glands ; and  giving 
others  to  the  neighbouring  lobes  of  the  lungs,  the 
pleura,  the  posterior  part  of  the  pericardium,  the 
pulmonary  sinus,  and  finally,  to  the  oesophagus. 

IV.  The  left,  or  superior  bronchial 
rising  transversely  to  the  left  bronchus , or  left 
division  of  the  trachea,  and  giving  branches  simi- 
lar to  the  former. 

V.  The  inferior  bronchial — issuingfrom 
the  aorta  at  the  fifth  vertebra,  and  accompanying 
the  bronchi,  in  the  course  of  the  pulmonary  vein 
to  the  internal  part  of  the  lungs  ; distributing- 
twigs  similar  to  the  former  bronchial. 

N.B.  Although  the  bronchial  arteries 
deserve  our  attention  from  their  inosculations  in 
the  substance  of  the  lungs  with  the  small  branches 
of  the  pulmonary  artery  ; yet  like  other  smaller 
vessels  they  exhibit  new  varieties  in  almost  every 
subject. 

VI.  CEsophageal  arteries — five  or  six  in 
number— slender — issuing  at  different  places,  from 


78 


the  trunk  under  the  bronchials , or  sometimes  from 
the  bronchials  themselves.  They  wind  on  the 
surface  of  the  oesophagus,  running  afterwards  to 
the  posterior  mediastinum  and  the  pericardium. 
Of  these,  the  largest  enters  the  abdomen  with  the 
oesophagus,  and  generally  inosculates  with  the 
coronary  oesophageal,  or  ascending  coronary  branch 
of  the  cceliac  and  phrenic  arteries. 

VII.  The  inferior,  or  aortic  intercos- 
ta ls — from  eight  to  ten  in  number — rise  from 
the  posterior  and  lateral  sides  of  the  trunk,  and, 
bending  to  the  interstices  of  the  ribs,  run  along 
their  inferior  margins.  As  the  branches  of  the 
right  side  must  pass  over  the  bodies  of  the  verte- 
bras, they  are  longer  than  those  of  the  left.  The 
four  or  six  superior  ones  are  smaller,  and  ascend  a 
little  ; while  the  inferior  proceed  transversely.  The 
first  superior , rising  at  the  fourth  vertebras,  and 
running  in  the  third  or  fourth  costal  interstice, 
inosculates  with  the  superior  intercostal  of  the  sub- 
clavian. The  last,  rising  behind  the  crura  of  the 
diaphragm,  passes  over  the  quadratus  lumborum  ; 
and  following  the  margin  of  the  last  rib,  is  distri- 
buted to  the  aponeurosis  of  the  transverse  muscle 
of  the  abdomen.  They  all  send, 

A.  Three  Branches — running  near  the  heads  of  the  ribs, 
to  the  spinal  cavity:  the  first  entering  the  bone;  the 
second,  the  dura  mater;  and  the  third  where  the  costal 
nerve  comes  out  entering  the  spinal  marrow. 

B.  Deep  Dorso. muscular  Branches — sent  to  the  dorsal 
muscles  : and  forming  a plexus  on  the  back. 


79 


N.  B.  The  preceding  twigs  sometimes  unite  into  one 
trunk. 

C.  A number  of  branches  to  the  intercostal  muscles; 
and,  after  penetrating  these,  distributed  to  the  serratus 
anticus,  pectoralis,  latissimus,  and  external  oblique. 

D.  The  Superior  Costal  Branch — the  smaller  division  of 
the  trunk — winding  from  the  angle  of  the  rib  to  its  supe- 
rior margin,  and  sometimes  forming,  as  it  runs  along,  the 
superior  ring  or  inosculation. 

E.  The  Inferior  Costal  Branch — exhibiting  a continu- 
ation of  the  trunk;  uniting  above  with  the  thoracics  and 
internal  mammary  ; below,  on  the  fore-part  of  the  abdo- 
men, with  the  epigastric  and  lumbar  branches.  It  forms 
the  principal  ring  with  the  mammary;  and  in  its  course 
gives  every  where  twigs  to  the  neighbouring  parts. 


IV.  ARTERIES  EROM  THE  ABDOMINAL  AORTA. 

The  Ventral  Aorta  is  the  lowest  part  of 
the  common  trunk.  It  passes  from  the  tho- 
rax, through  the  inferior  muscle  of  the  dia- 
phragmj  to  the  right  side  of  the  (Esophagus,  in 
a straight  direction,  inclining  rather  to  the 
left ; and,  proceeds  gradually  through  the 
abdomen,  upon  the  surface  of  the  vertebral 
column  to  the  fifth  lumbar  vertebra,  or  thick 
ligament  connecting  the  fourth  and  fifth.  The 
inner  or  long  crura  of  the  diaphragm,  various- 
ly interwoven  behind  the  (Esophagus,  separate. 


80 


anteriorly  on  the  aorta,  allowing  a passage, 
through  which  it  descends,  resting  posteriorly 
on  the  vertebral  column.  This  passage  is  con- 
siderably larger  than  the  trunk,  loose  cellular 
substance,  connecting  the  pleura  and  perito- 
neum, being  interposed.  The  aorta  at  this 
place  is  separated  from  the  vena  cava  by  the 
left  lobe  of  the  liver,  a part  of  the  diaphragm, 
and  a large  quantity  of  cellular  substance  ; 
but  in  the  space  between  the  kidneys  and  the 
liver,  these  two  vessels  approach  so  near,  that 
the  right  margin  of  the  artery  is  partly  cover- 
ed by  the  vein  that  afterwards  send  some  of  its 
branches  anteriorly  across. 

The  Abdominal  Aorta  is  divided  at  the  ver- 
tebra, mentioned  above,  into  two  branches  of 
equal  size,  forming  an  acute  angle  as  they  run 
towards  the  brim  of  the  pelvis.  These,  ana- 
tomists have  called  iliacte  communes , or  Com- 
mon Iliacs.  The  branches  of  the  ventral  aorta 
are  best  described  in  the  order  in  which  they 
occur. 

I.  The  phrenic  artery — Right  and  Left — 
very  irregular  in  origin  and  division.  Sometimes 


81 


a single  trunk,  rising  above  the  c celiac,  divides 
into  the  right  and  left  phrenic.  Sometimes  again, 
and  indeed  most  frequently,  the  right  rises  from 
the  cceliac , and  the  left  from  the  aorta  ; while,  at 
other  times,  they  have  been  observed  rising  toge- 
ther, both  from  the  cceliac , or  both  from  the  aorta. 
Sometimes  the  single  trunk,  or  common  phrenic. 
being  larger  than  usual,  constitutes  the  fourth 
branch  of  the  cceliac , and  then  forms  the  superior 
coronary  branch  of  the  stomach.  There  are  some- 
times three  or  four  phrenic  arteries,  which,  as  soon 
as  they  arise,  bend  obliquely  outwards,  before  the 
crura  of  the  diaphragm,  to  the  inferior  margin  of  its 
tendenous  alas ; and,  while  they  here  wind  tortuous- 
ly under  its  fleshy  fibres,  distribute  various  twigs 
upwards,  outwards,  inwards,  and  downwards. 
Bending  at  last  to  the  external  margin  of  the  ten- 
don, and  passing  between  the  muscular  layers,  they 
run  forwards,  and  inosculate  upon  the  costal  mus- 
cles, with  the  thoracic  vessels,  and  the  artery  of 
the  opposite  side.  At  the  bend  of  the  artery, 
however,  they  send  a larger  branch  to  the  poste- 
rior and  inferior  portion  of  the  diaphragm  as  it  rises 
from  the  ribs.  Besides  the  branches  of  the  dia- 
phragmatic tendon  and  muscle,  the  following  like- 
wise merit  attention. 

A.  Branches  going  to  the  two  sides  of  the  renal  capsules, 
and  adipose  substance  lying  on  the  kidneys.  See  a des- 
cription of  these  arteries  below. 

B.  Branches — uniting,  after  penetrating  the  diaphragm, 

10 


82 


with  the  accompanying  branch  of  the  phrenic  nerve,  and 
the  other  phrenics  rising  from  the  mammary. 

C.  Branches — some  passing  on  the  right  side  to  the  pan- 
creas, liver,  and  vena  cava,  others  accompanying  the  vena 
cava  to  the  pericardium,  the  posterior  surface  of  the  liver, 
and  its  suspensory  ligament ; inosculating,  in  many  places, 
with  the  hepatic  arteries.  Upon  the  left,  they  run  to  the 
left  lobe  of  the  liver,  the  ligament  of  the  spleen,  the  oeso- 
phagus, and  cardia. 

N.  B.  The  diaphragm  sometimes  receives  wandering 
branches  from  the  cccliac , inferior  intercoslals , the  cupsu- 
lars , and  the  lumburs , particularly  from  the  second  lumbar. 

II.  The  cceliac  artery — short,  but  of  large 
diameter — rising  between  the  crura  of  the  dia- 
phragm, above  the  eleventh  dorsal  vertebra,  from 
the  anterior  part  of  the  aorta,  and  at  the  superior 
margin  of  the  pancreas,  between  the  papillary 
lobule,  or  lobule  of  Spigelius,  and  the  left  side  of 
the  lesser  arch  of  the  stomach.  It  then  descends 
in  a tortuous  manner,  forwards,  and  to  the  right, 
and  running  about  the  third  of  an  inch,  ultimately 
separates  into  three  branches,  in  such  a manner, 
that  the  two  on  the  right  seem  to  arise  from  a 
common  base ; while  the  left  is  more  distinct  at 
its  origin.  These  are 

A.  The  Superior  Coronary , or  Great  Left  Gas- 
tric, or  Superior  or  Left  Gastro  hepatic — smaller 
than  the  other  branches  if  reflected  only  to  the 
stomach,  but  almost  squal  in  size  to  the  splenic , 
if,  as  sometimes  happens,  it  sends  a branch  also  to 
the  liver.  It  appears  sometimes  to  issue  from  the 
splenic  ; ascends  to  the  left,  and  forwards  to  the 


83 


cardia  and  lesser  arch  of  the  stomach  ; then  bend- 
ing downwards,  and  to  the  right,  reaches  the  mar- 
gin of  the  stomach,  where  it  distributes  extensively 
its  circuitous  branches,  forming  a corona  to  both 
sides  of  the  stomach.  Of  these,  the  principal  are 

A superior  Branch — running  transversely  upon  the  an- 
terior surface  to  the  greater  arch  of  the  stomach,  and  that 
place  where  the  oesophagus  is  dilated  into  a sac. 

The  Inferior , or  Right  C’orowary-— sometimes  double — - 
descending,  by  the  lesser  arch  of  the  stomach,  towards  the 
pylorus ; 

The  Left  Hepatic. — This  artery,  when  present,  termi- 
nates the  trunk.  Sometimes  the  gastric , after  the  former 
branches  are  sen  t off,  runs  immediately  upwards,  and  to 
the  right ; and  sinking  between  the  lesser  arch  of  the  sto- 
mach and  the  left  lobe  of  the  liver  in  the  transverse  fossa, 
is  variously  ramified  to  the  left  lobe,  the  lobule  of  Spige. 
lius,  the  umbilical  fossa  and  the  venous  duct , at  other  times 
these  branches  arise  from  the  coeliac  hepatic. 

B.  The  Hepatic. — This  artery,  which  in  adults 
is  smaller  than  the  splenic , but  children  larger,  rises 
from  the  right  side  of  the  coeliac , or,  as  sometimes 
happens,  from  the  superior  mesenteric ; when, 
turning  upwards  near  the  outer  point  of  the  lobule 
of  Spigelius  it  is  concealed  by  the  pancreas  ; then 
proceeding  forwards,  upwards,  and  to  the  right,  be- 
hind the  right  extremity  of  the  stomach  and  the 
duodenum,  it  observes  the  same  obliquity  as  the 
lesser  arch  ; and,  after  running  an  inch,  or  an  inch 
and  an  half,  divides,  below  the  neck  of  the  gall 
bladder,  into  the  right  transverse  and  left  ascend - 


84 


ing  hepatics;  entering-,  at  last,  with  the  other  hepatic 
vessels,  the  transverse  fissure  or  fossa  of  the  liver. 
Enclosed  in  the  capsule  of  Glisson,  it  occupies  a 
middle  space  between  the  biliary  ducts  and  the 
vena  porta.  Before  its  division,  it  sends 

Many  small  pancreatic  branches. 

Minute  branches  to  the  lesser  omentum  and  vena  porta. 

The  Duodeno.Gastric,  or  Gastro-duodenal , or  Pancre- 
atico-duodenal — rising  at  a right  angle  from  the  trunk, 
and,  behind  the  pylorus,  proceeds  forward  between  the 
commencement  of  the  duodenum  and  the  head  of  the  pan- 
creas, and  without  forming  a connection  with  this  gland, 
reaches  the  last  curvature  of  the  duodenum  : then  inclin- 
ing to  the  larger  arch  of  the  stomach  on  the  left,  and  enter- 
ing the  web  of  the  omentum,  it  inosculates,  in  the  middle 
of  the  great  arch  of  the  stomach,  with  the  left  gastro  epi- 
ploic. From  this  are  sent 

Small  Pancreatic  branches. 

The  Inferior  Pyloric — passing  to  the  right,  and  distri- 
buting its  branches  under  the  duodenum,  to  the  space  be- 
tween the  curvatures  of  the  stomach,  and  the  first  flexure 
of  the  intestine;  some  of  which  inosculate  with  the  supe- 
rior pylorics , and  others  with  the  right  gastro. epiploic. 

Small  Duodenal  Branches — passing  from  the  trunk 
behind  the  commencement  of  the  duodenum.  Sometimes 
wanting. 

The  Right  Superior  Duodenal — sometimes  double  or 
triple,  and  frequently  issuing  from  the  hepatic.  Passing 
the  choledic  duct,  it  winds  on  the  posterior  surface  of  the 
first  transverse  and  descending  flexion  of  the  duodenum  ; 
when  turning  to  the  right  margin  of  the  pancreas,  and  the 
lowest  posterior  part  of  the  second  flexion  of  the  duode- 
num, it  inosculates  on  the  left  with  the  inferior  mesenteric 
duodenal.  It  sometimes  winds,  in  a similar  manner,  on 


85 


the  posterior  surface  of  the  duodenum ; and  upon  its 
anterior  with  the  pancreatico-duodenal. 

The  Pancreatico  duodenal — traversing  the  inner  curva- 
ture of  the  duodenum  in  the  form  of  a semicircle,  and 
sending  numerous  branches  outwards  to  the  perpendicular 
and  second  transverse  portions  of  the  duodenum  ; and 
inwards  to  the  head  of  the  pancreas;  at  last  inosculates 
with  the  duodenals  of  the  mesenteric. 

The  Transverse  Pancreatic — rising,  near  the  inferior 
margin  of  the  first  flexion  of  the  duodenum  ; and  passing 
to  the  left  over  two  thirds  of  the  posterior  surface  of  the 
pancreas,  gives  every  where  twigs  to  the  substance  of  the 
eland  and  mesocolon.  It  sometimes  rises  from  the  me. 
senteric,  and  sometimes  from  the  splenic. 

The  Right  G astro  Epiploic , or  Right  Gastric , or 
Inferior  Coronary — exhibiting  a continuation  of  the 
trunk,  as  it  bends  to  greater  arch.  Passing  obliquely 
downwards,  behind  the  pylorus,  to  the  posterior  side  of 
the  stomach,  it  is  connected  by  means  of  the  omentum,  to 
the  greater  arch  ; and  traversing  its  margin  to  the  left,  at 
last  disappears  in  the  left  gastro. epiploic. 

The  Superior  Hepatico-P yloric , Small  Right  Gastric , 
or  Lesser  Coronary. — According  as  the  hepatic  divides, 
soon  or  later,  this  artery  arises  from  its  trunk,  or  its  left 
branch  : and  reflected,  with  a very  acute  angle  to  the  lesser 
arch,  there  inosculates,  in  various  places  with  th q pyloric 
or  coronary  artery ; 

The  Left  Hepatic — the  lesser  branch  of  divided  trunk, 
and  often  wanting  when  the  hepatic  rises  from  the  corona - 
ry.  It  first  proceeds,  with  the  trunk,  parallel  to  the  vena 
porta  ; then  mounting  over  the  trunk,  enters  the  umbilical 
fossa  ; where  it  sends, 

Branches  to  the  substance  of  the  liver  near  the  venous 
duct,  to  the  lobule  of  Spigelius,  the  left  lobule,  and  lobu- 
lus  anomymus. 


86 


The  Right  or  Biliary  Hepatic — covered  by  the  biliary 
ducts,  conceals  itself  in  the  right  extremity  of  the  trans- 
verse fossa — sometimes  rises  from  the  superior  mesenteric 
— is  sometimes  double. 

C.  The  Splenic. — While  this  artery  runs  along 
the  upper  surface  of  the  pancreas,  an-  passes  trans- 
versely to  the  depression  of  the  spleen,  it  exhibits 
large  and  repeated  flexions,  upwards  and  down- 
wards, bending  in  a circular  or  spiral  form.  Ap- 
proaching the  substance  of  the  spleen,  it  divides 
into  many  branches,  which  are  equally  tortuous : 
and  of  those  that  sink  into  the  spleen,  some  small- 
er ones  return  through  its  substance  to  the  dia- 
phragm or  stomach.  Its  most  remarkable  branches 
are, 

The  Great  Pancreatic — irregular  both  in  size  and 
direction.  The  whole  branch  is  sometimes  covered  by  the 
pancreas ; and,  passing  to  the  right  extremity  of  this  gland, 
supplies  it  with  twigs;  sending  others,  at  times,  to  the 
adjoining  duodenum  and  mesocolon.  If  the  trunk  divides, 
another  branch,  bending  to  the  left,  supplies  the  place  of 
the  transverse  pancreatic.  It  inosculates  with  the  pylorics 
and  duodenals. 

Small  pancreatics — descending  from  the  splenic , in 
great  numbers,  through  its  whole  extent. 

Posterior  Gastrics — two  or  four  in  number — sometimes 
wanting — rising  from  the  middle  of  the  trunk  as  it  passes 
to  the  spleen,  and  ascending  with  the  omentum  to  the  pos- 
terior surface  of  the  large  extremity  of  the  stomach. 

The  Left  Gastro  epiploic , or  Left  Gastric — often  double, 
rising  near  the  commencement  or  left  extremity  of  the  pan- 
creas, where  the  trunk  begins  to  divide,  bends  downwards 
and  to  the  right,  with  its  two  branches  to  the  fundus,  and 


87 


larger  arcli  of  the  stomach ; and,  like  the  right  gastric , 
with  which  it  inosculates,  follows  the  large  curvature  of 
the  stomach. 

Pancreatic  Branches. 

Large  Epiploics — three  or  four  in  number;  one  of 
which  is  usually  larger  than  the  rest,  but  all  distributed 
to  the  omentum  and  colon. 

Gastric  Branches,— inosculating  with  the  coronaries  on 
the  surface  of  the  stomach. 

The  Vasa  Brevia , or  Short  Branches — three  or  four  in 
number — issue  from  the  trunk  as  it  reaches  the  depression 
of  the  spleen  ; and  distribute  their  ramuli  to  the  fundus  of 
the  stomach,  where  they  spread  in  various  directions,  on 
its  surface,  and  inosculates  with  many  of  the  neighbouring 
branches. 

III.  The  superior  mesenteric — the  largest 
of  the  abdominal  or  ventral  branches,  rising  be- 
tween the  crura  of  the  diaphragm,  three  or  four 
lines  below  the  cceliac , from  the  anterior  part  of  the 
aorta,  and  under  the  lower  edge  of  the  pancreas ; 
proceeds  between  this  gland  and  the  inferior  trans- 
verse flexion  of  the  duodenum.  Passing  over  this 
portion  of  the  intestine,  it  bends  to  the  right  under 
the  mesocolon ; where,  received  near  the  vertebrae 
into  the  folds  of  the  mesentery,  it  first  inclines  to 
the  left  and  then  to  the  right ; where  the  whole 
artery,  advancing  to  the  right  ilium,  assumes  the 
form  of  the  Roman  S,  with  the  concave  side  of  its 
large  curvature  looking  to  the  right.  After  giving 
oft'  smaller  branches,  the  trunk  sends  from  its  right 
side  only  two  branches  to  the  large  intestines  ; but 
from  the  left  it  gives  a greater  number  of  branches 
to  the  small  intestines.  These  are, 


88 


A.  Posterior  Pancreatics — numerous — penetrating  the 
right  and  left  side  of  the  pancreas,  and  inosculating  with 
the  pancrealico  duodenal,  transverse  pancreatic,  and  the 
splenico.puncreatics.  Some  of  these  pass  through  the 
mesocolon  to  the  colon  itself. 

B.  The  Left  Inferior  Duodenal — two  or  three  of  them 
— rising  from  the  left  side  of  the  trunk,  and  stretching 
to  the  inferior  and  left  curvature  of  the  intestine.  While 
some  twigs  are  reflected,  upwards  and  backwards,  in  the 
form  of  arches,  the  rest  inosculate  variously  with  the 
superior  duodenals,  the  pancreatico  duodenal  before  this 
gland,  and  w ith  their  fellows.  These  branches,  however, 
are  very  irregular. 

C.  The  Superior  or  Medio. colic — rises  sometimes  above 
the  duodenal  branches;  but  generally  below  them  under 
the  duplicature  of  the  mesocolon,  and  runs  along  the 
transverse  mesocolon  from  the  left,  forwards  and  to  the 
right,  to  the  right  colon  and  adjoining  part  of  the  trans. 
verse  colon.  It  sometimes  rises  double:  but  more  fre- 
quently, after  running  a short  way  upon  the  mesocolon, 
divides  into  two  branches,  viz. 

The  Transverse  Colic — passing,  in  the  duplicature, 
along  the  middle  of  the  mesocolon  to  the  concave  side  of 
the  transverse  colon,  after  having  first  divided,  sooner  or 
later,  about  three  inches  from  the  edge  of  the  intestine, 
into  two  diverging  branches. 

The  Superior  Right  Colic — sometimes  rising,  by  a se-  * 
parate  trunk,  from  the  mesenteric  ; proceeds  transversely 
and  to  the  right,  in  the  duplicature  of  the  mesocolon,  to 
the  hepatic  flexure  of  the  colon  ; and  where  it  approaches 
the  intestine,  gives 

D.  The  Ileo  Colic — This  artery  rises  single  from  the 
right  side  of  the  trunk,  about  an  inch  or  two  below  the 
last,  and  below  the  transverse  mesocolon.  It  afterwards 
proceeds  behind  the  right  mesocolon,  and  descends  beyond 
the  psoas  muscle  to  the  junction  of  the  ileum  and  caecum. 
Its  principal  branches,  are 


89 


A Curved  Ascending  Branch — distributing  twigs  to  the 
right  colon,  and  uniting  with  the  descending  branch  of 

the  superior  right  colic. 

Inferior  Right  Colics — rising  sometimes  from  the 
former,  and  running,  with  a double  branch  to  the  adjoin- 
ing intestine. 

A Ccecal  Branch — larger  than  the  former,  and  directing 
its  course,  with  its  trunk  the  ileo. colic  to  the  ccecum.  It 
gives  out, 

The  Anterior  Ccecal — passing  along  the  anterior  fold 
between  the  ileum  and  coscum,  and  distributing  its 
branches  upon  the  anterior  part  of  the  ccecum. 

The  Posterior  Ccecal — running  to  the  posterior  surface 
of  the  ccecum,  giving  branches  to  the  root  of  the  verniform 
process,  and  inosculating,  near  the  right  of  the  ccecum, 
with  the  former  artery  and  with  the  appendicular. 

The  Appendicular — reaching,  behind  the  ccecum,  to  the 
small  mesentery  of  the  vermiform  process  ; and,  as  it  runs 
along  this,  giving  straight  and  short  twigs  to  the  process. 

An  Iliac  Branch — winding  to  the  left,  and  forming  an 
arch  near  the  ileum,  with  the  extremity  of  the  mesenteric 
trunk,  from  which  the  ileum  receives  new  branches. 

Branches,  varying  in  number,  from  twelve  to  twenty, 
rise  close  to  one  another,  from  the  left  convex  side  of  the 
superior  mesenteric,  distributing  ramuli  to  the  ileum  and 
jejunum.  Of  these  the  superior  are  short  and  slender; 
the  middle  long  and  thick  ; the  interior  shortest ; and  the 
last  branch  of  all,  as  observed  above,  inosculates  with 
the  ileo-colic.  Running  near  and  parallel  to  each  other, 
they  first  proceed  transversely  ; then  rising  between  the 
layers  of  the  mesentery,  divide  into  smaller  branches, 
which  so  diverge,  that  in  whatever  direction  they  go,  they 
are  soon  after  divided  into  two.  These  branches,  as  they 
meet,  form  various  arches,  from  whose  convex  margin, 
new  parallel  branches  arise ; which  again  soon  dividing, 
inosculate  with  the  adjacent  branches,  forming  smaller 
11 


90 


and  more  numerous  arches.  From  the  convexity  of  these 
arches  other  branches  arise,  forming  a third  series  of 
arches;  and  where  the  branches  are  longest,  even  a fourth 
or  fifth  series;  till  the  last  branches  near  the  intestines, 
dividing  into  anterior  and  posterior,  encircle  these  viscera, 
and,  gradually  penetrating  their  coats,  form  most  beauti- 
ful arborescent  ramifications  on  their  cellular  membrane. 
These  arches,  by  means  of  their  twigs,  not  only  form  vari- 
ous inosculations  among  themselves,  but  also  with  the  ar- 
borescent ramifications  of  the  two  surfaces.  The  inner 
intestinal  coat  is  so  covered  by  these  branches  and  the  veins, 
as  to  give  it  the  appearance  of  being  wholly  vascular.  The 
trunks  of  these  arborescents  lie  on  the  roots  of  the  valvulcc. 
The  arches  are  polygons ; and  the  first  series  larger  than 
the  rest.  The  lymphatic  glands,  and  coats  of  the  vessels, 
are  surrounded  with  numerous  and  various  tw  igs,  as  va- 
riously distributed. 

N.  B.  The  more  slender  branches  of  the  mesenteric 
generally  inosculate  freely  with  the  spermatic  arteries, 
near  the  duodenum  and  commencement  of  the  small  intes- 
tines, and  with  the  capsular  and  adipose  branches. 

Singular,  likewise,  is  that  inosculation,  which  the 
mesenteric  forms  with  the  epigastric  in  the  foetus. 

IV.  The  INFERIOR  MESENTERIC,  Of  LEFT 
colic. — This  artery  rises  between  the  renal  and 
common  iliacs,  from  the  anterior  and  left  side  of 
the  aorta  ; descends  behind  the  peritoneum  to  the 
left  side  of  the  trunk ; and,  having  reached  that 
place  where  the  aorta  divides  into  two  remarkable 
crura,  forming  the  iliacs,  sends  off  a large  branch ; 
and,  after  passing  the  iliac  artery,  sinks  behind  the 
rectum  into  the  pelvis.  As  it  here  rises  forward 
and  to  the  right,  it  enters  the  duplicature  of  the 


91 


mesorectum,  and  accompanies  the  intestine  as  far 
as  its  internal  sphincter.  It  sends  out 


A.  One  or  two  brandies,  near  its  origin,  distributed  to 
the  lumbar  glands  and  the  peritoneum,  and  inosculating, 
upon  the  left  side,  with  some  branches  of  the  spermatics. 

B.  The  Left  Colic — a thick,  but  very  short  artery; 
often  about  two  lines  in  length,  and  issuing  from  the  place 
just  mentioned,  runs  in  the  duplicature of  the  left  mesoco- 
lon to  the  left  side,  and  divides  into  three  widely  diverging 
branches,  viz. 

The  Ascending  Branch — rising  to  the  left  angle  of  the 
transverse  mesocolon ; 

The  Transverse  Branch — running  often  double  or  triple, 
to  the  left  colon  ; but  first  dividing,  and  sending  a branch, 
which  inosculates  upwards  with  the  ascending , and  down- 
wards with  the  descending  branch. 

The  Descending  Branch — running  to  the  last  portion  of 
the  left  colon,  and  its  iliac  flexure  ; varies  in  the  size  and 
number  of  its  branches,  according  as  the  curvature  of  the 
intestine  is  greater  or  less.  It  is  often  divided  into  three 
branches,  which  form  anastomotic  arches  among  them- 
selves, and  with  the  former. 

N.  B.  The  Left  Colic  gives  out  also  branches,  forming 
a plexus  with  the  lumbar  branches,  and  with  smaller 
twigs  of  the  spermatics. 

C.  The  Internal  Hcemorrhoidal This  name  is  given 

to  the  trunk  when  it  reaches  and  runs  along  the  posterior 
part  of  the  rectum.  It  gives  out 

One  or  two  branches  to  the  lower  part  of  the  colon. 

Branches  encircling  the  rectum,  and  uniting  anteriorly, 
without  forming  an  intermediate  arch. 

Branches  which,  with  the  middle  hcemorrhoidaf  the 
lowest  vesical  or  uterine  branch  of  the  hypogastric , inos- 
culate freely  at  the  inferior  part  of  the  intestine,  which 
this  artery  does  not  reach. 


92 


V.  Capsular,  or  atrabiliary — Right  and 
Left.  These  are  distinct  small  arteries,  which, 
though  never  wanting,  as  they  distribute  many 
branches  to  the  capsular  gland,  yet,  in  almost  every 
individual,  they  present  irregularities  in  number, 
size,  or  direction.  They  do  not,  like  the  vein, 
issue  from  one  common  trunk,  but  from  the  vari- 
ous branches,  coming  together  near  the  seat  of  the 
gland ; and  may  therefore  be  divided  into  three 
classes. 

A.  The  Superior  Capsular  Branches — from  two  to  four 
in  number — rising  from  the  inferior  phrenics,  from  their 
common  trunk,  or  from  the  transverse  branch;  spread 
variously  upon  both  sides  of  the  gland,  and  supply  the  fat 
which  surrounds  the  kidneys,  with  various  twigs. 

B.  The  Middle  Capsulars — very  often  double — sent 
from  the  aorta,  between  the  phrenics  and  superior  mesen- 
teric. These  small  branches,  proceeding  transversely  to 
the  gland,  soon  divide;  and  give 

Anterior  and  posterior  branches  to  the  gland. 

Small  Phrenic  and  Adipose  Branches. 

Branches,  running  upon  the  right  side,  to  tfie  nearest 
part  of  the  liver,  the  vena  cava,  the  coverings  of  the  duo. 
denum,  and  the  right  mesocolon  ; and  upon  the  left  to  the 
surface  of  the  spleen  and  adjoining  mesocolon.  They  fre- 
quently unite  with  the  arteries  belonging  to  those  viscera. 

C.  The  Inferior  Capsular — two  or  three  in  number — 
rising  from  the  superior  edge  of  the  renal  artery.  They 
ascend  outwards;  and,  after  reaching  the  gland,  if  they  be 
of  considerable  size,  communicate  wandering,  but  nume. 
rous  branches  to  the  neighbouring  viscera,  the  renal  fat,, 
and  the  adjacent  arteries,  particularly  the  spermatics. 


93 


VI.  The  renal,  or  emulgent  artery — 
Right  and  Left.  It  is  unnecessary  to  enumerate 
the  varieties  which  anatomists  have  observed,  as  to 
the  number,  origin,  and  magnitude  of  this  artery. 
It  generally  rises  single  from  the  side  of  the  aorta ; 
between  the  superior  and  inferior  mesenteric  arte- 
ries, from  which  it  descends  transversely  at  less 
than  a right  angle.  The  left,  which  is  rather 
shorter  than  the  right , and  more  posterior  in  its 
origin,  turns,  near  the  kidney,  over  its  concomitant 
vein ; while  the  right , which  is  longer,  is  covered 
by  its  concomitant  vein.  Approaching  the  renal 
depression,  it  divides  into  two  or  four  branches  ; 
which,  sinking  separately  before  and  behind  the 
pelvis  of  the  kidney,  are  again  divided,  and  distri- 
bute their  spreading  branches  to  the  papillary  cones. 
These,  as  they  encircle  the  convex  margin  of  the 
papillae,  form  arches  with  the  adjoining  branches, 
and  seem  to  separate  the  cortical  from  the  tubular 
substance.  From  the  convex  and  concave  mar- 
gin of  each  arch,  rise  innumerable  small  arteries  ; 
of  which  the  former  encircle  the  cortex,  and  with 
some  of  their  branches  pass  through  its  substance 
and  disappear  on  the  fat ; while  the  rest  are  chiefly 
dispersed  and  exhausted  upon  the  tubular  part. 
Before  entering  the  kidney,  the  renals  give  out, 

A.  The  Inferior  Capsulars. 

B.  Small  Phrenics  to  the  crura  of  the  diaphragm. 

C.  Many  Adipose  Branches.  See  below. 

D.  The  Superior  Ureteric.  See  below. 


94 


E.  Spermatic  Arteries,  inosculating  sometimes  with  the 
spermatic  branches. 

F Smaller  branches,  distributed  to  the  mesocolon  of 
each  side. 

VII.  The  spermatic  artery — Right  and 
Left — This  artery  is  very  slender,  but  considering 
the  smallness  of  its  diameter,  is  the  longest  that 
rises  from  the  lateral  part  of  the  aorta.  It  generally 
has  its  origin  between  the  renal  and  mesenteric 
arteries,  though  the  right  and  left  do  not  always 
issue  from  the  same  place ; the  left  often  rising 
higher,  and  proceeding  frequently  from  the  renal 
or  the  inferior  capsular.  I have  observed,  at  times, 
two  on  each  side.  It  descends  from  the  aorta 
somewhat  tortuously,  at  a very  acute  angle,  behind 
the  peritoneum,  and  passes  before  the  vena  cava  on 
the  right  side.  It  is  more  tortuous  in  women  than 
in  men,  in  whom  it  passes  through  the  abdominal 
ring.  It  joins  its  concomitant  vein  upon  the  sur- 
face of  the  psoas  muscle.  Received  by  the  sper- 
matic cord,  it  is  divided,  at  some  inches  before 
reaching  the  testes,  into  five  branches : two  of 
which  go  to  the  head  and  opposite  extremity  of 
the  epididymis ; while  the  rest  running  down  to 
the  testicle  itself,  penetrate  the  tunica  albuginea, 
and  send  off  new  branches  in  every  direction ; 
which,  proceeding  in  a winding  course,  and  re- 
flected to  the  inferior  margin  of  the  testes,  are 
parti)  exhausted  on  its  substance,  and  partly  on 
the  convolutions  of  the  seminiferous  ducts.  With- 


95 


out  any  perceptible  diminution  of  diameter,  the 
artery  sends  out  in  this  cout'se, 

A.  Middle  and  Inferior  Adipose  Branches — traversing 
the  middle  region  of  the  kidney.  See  below. 

B.  Superior  Ureterics.  See  below. 

C.  Branches  to  the  duodenum,  the  vena  cava,  and  liver 
on  the  right ; and  to  the  mesocolon  on  the  left. 

D.  Branches  to  the  lumbar  glands,  peritoneum,  and  the 
spermatic  veins. 

E.  Branches  terminating  in  the  spermatic  cord,  and 
chiefly  in  the  cremaster  muscle,  and  the  sceptum  of  the 
scrotum. 

In  females  the  artery  does  not  pass  through  the  ring, 
but  enters  the  broad  ligaments. 

VIII.  Adipose  arteries. — -Right  and  Left 
— These  vessels  distributed  to  the  adipose  sub- 
stance round  the  kidneys,  are,  on  account  of  their 
number  and  origin,  divided,  like  the  capsular,  into 
certain  classes. 

1.  Superior  Adipose  Branches,  rising  from  all  the  cap- 
sulars,  viz.  the  phrenic , aortic , renal , and  first  lumbar , 
running  extensively  upon  the  superior,  posterior,  and  ex- 
terior adipose  substance  of  the  kidney. 

2 Middle  Adipose  Branches — sent  out  below  the  renal 
artery,  from  the  renal  spermatic  and  the  aorta,  to  the  mid- 
dle adipose  substance  of  the  kidney. 

3.  The  Inferior  Adipose  Branch — rising  from  th esper. 
matic , below  the  lower  extremity  of  the  kidney  ; and 
bending  to  its  posterior  and  inferior  adipose  substance, 
inosculates  with  the  superior  adipose  branches,  the  ileo- 
colics , and  twigs  from  the  spermatic. 


96 


IX.  The  ureteric  arteries — which  may  be 
reckoned  among  the  smallest  branches  of  the  aorta, 
approach  the  ureter  in  different  places  ; and  may 
likewise  be  divided  into, 

1.  Superior  TJ  ref  erics — rising  from  the  renal  artery, 
the  inferior  cupsulars , and  spennalics , run  to  the  pelvis  of 
the  kidney,  and  the  upper  part  of  the  ureter. 

2.  Middle  Ureterics — issuing  from  the  aorta,  a little 
above  its  bifurcation,  or  from  the  common  iliac  or  sperma- 
tic, run,  with  minute  twigs,  extensively,  upwards  and 
downwards,  upon  the  middle  part  of  the  ureter,  proceed- 
ing to  the  peritoneum  of  the  pelvis  and  the  lumbar  glands. 

3.  The  Inferior  Ureteric — rising  from  the  inferior  ve. 
sicals  or  uterine,  near  the  insertion  of  the  ureter  into  the 
bladder,  inosculates,  upon  the  bladder,  with  the  former 
branches,  sending  otf,  in  every  direction,  minute  ramuli 
through  the  whole  of  the  canal. 

X.  The  lumbar  arteries — Right  and  Left. 
— Five  in  number,  issuing  from  the  lateral  and  pos- 
terior part  of  the  aorta,  at  nearly  a right  angle.  The 
first  runs  transversely  under  the  first  vertebra  of 
the  loins.  The  fifth  between  the  last  vertebra  and 
os  sacrum,  and  the  rest  between  the  vertebral  inter- 
stices ; while  all  of  them  after  being  reflected 
round  the  spine,  sink  into  the  intervening  spaces 
of  the  vertebrae.  The  right  are  longer  than  the 
left.  The  superior  proceeding  in  a straight  line, 
while  the  inferior  incline  a little  downwards.  Two 
sometimes  arise  from  a single  trunk  ; and  all,  ex- 
cept the  first,  are  covered  by  the  psoas  muscle. 


97 


They  agree  in  this,  that  each  sends  to  the  adjoin- 
ing intervertebral  space, 

A.  Two  Spinal  Branches — rising  sometimes  separately, 
but  most  commonly  by  one  trunk,  and  running  in  the 
course  of  the  nerve,  as  it  comes  out  from  the  spinal  mar- 
row. The  first  is  larger,  entering  the  involucrum  that 
lines  the  vertebrae,  forming  a plexus  with  the  neighbour- 
ing arteries,  and  constituting  arches  that  encircle  the 
membrane.  The  second , after  sending  a branch  to  this 
membrane  and  the  bone,  sinks  into  the  medulla. 

B.  Muscular  Branches — w hich  are  again  divided  into 
Anterior  Branches — distributed  to  the  psoas,  lumbar, 

quadratus,  and  abdominal  muscles  ; and  interwoven  ante- 
riorly with  the  intercostals,  the  epigastrics,  and  the 
adjoining  arteries  of  the  same  class. 

Posterior  Branches — -ramified  on  the  posterior  lumbar 
muscles,  inosculating  upon  these  and  the  surface  of  the 
bones  ; and  running,  with  various  twigs  to  the  skin. 

The  first  lumbar  passes  behind  the  crura 
of  the  diaphragm,  and,  penetrating  the  psoas, 
bends  anteriorly  between  the  transverse  muscle 
and  the  internal  oblique.  Besides  the  spinals  al- 
ready mentioned,  it  gives 

1.  A Phrenic  Branch — inosculating  with  the  former 
phrenics  and  adipose  branches 

2.  Branches  to  the  quadratus,  psoas,  and  dorsal  mus- 
cles. 

3.  Branches  to  the  abdominal  muscles,  where  they  reach 
the  inferior  intercostals  and  the  following  lumbars. 

12 


98 


The  fourth  lumbar  sometimes  goes  out 
from  a common  trunk  with  its  fellow.  Of  its  an- 
terior branches,  one  winds  around  the  crest  of  the 
ileum,  and  is  exhausted  upon  the  transverse  and 
the  internal  iliac  muscles,  where  also  it  inosculates 
with  the  branches  of  the  ileo-lumbar. 

The  fifth  lumbar,  shorter  than  the  others, 
arises  from  the  common  iliac , or  sometimes  from 
the  ileo-lumbar ; gives  posterior  branches  similar 
to  those  of  the  preceding  arteries  ; but  its  anterior 
branches  go  only  to  the  internal  iliac  muscle,  and 
inosculate  with  the  sacro-lateral  artery. 


V.  ARTERIES  WHICH  TERMINATE  THE  AORTA. 

The  aorta  on  reaching  the  fourth  lumbar 
vertebra  terminates  in  two  great  vessels  called 


THE  PRIMITIVE  ILIACS. 

These  arteries  are  equal  in  size  and  length. 
They  run  obliquely  outwards,  downwards  and 
a little  forwards,  gradually  quitting  the  fifth 
lumbar  vertebra  on  which  they  are  at  first 
placed.  They  pass  before  the  lateral  parts  of 
the  base  of  the  sacrum  and  near  the  sacro-iliac 


99 


symphyses  divide  into  two  considerable  ves- 
sels, named  external  and  internal  iliac. 

In  this  short  course,  the  two  primitive  iliacs 
run  along  the  inner  edge  of  the  psoas  mus- 
cles ; and  are  separated  from  each  other  by  a 
quantity  of  cellular  membrane.  On  the  fore 
part,  the  right  is  in  a great  measure  covered 
by  the  vena  cava  inferior;  the  peritoneum 
alone  covers  the  left.  No  branch  is  given  off 
by  them  : except  at  the  place  of  their  bifur- 
cation, where  an  artery  is  sent  off  called 

I.  The  sacro-medi an — of  the  same  size 
as  the  lumbar ; it  is  an  azygos  artery ; and,  ris- 
ing from  the  bifurcation,  or  a little  higher 
from  the  middle  of  the  aorta,  or  from  one  of 
the  lumbars , or  sometimes  from  the  iliac,  runs 
down  along  the  middle  of  the  anterior  surface 
of  the  os  sacrum,  as  far  as  the  coccyx,  where 
it  forms,  with  the  sacr o-laterals,  an  arch  that  is 
convex  downwards.  In  its  descent  it  gives 

Transverse  Brandies;  three  or  four  in  number;  run. 
ning  outwards  in  undulating  lines,  and  communicating, 
upon  the  surface  of  the  sacral  vertebrae,  with  the  sacro.la- 
terals.  r]^he  first  generally  inosculates  with  the  last  lum . 
bar  and  ileo.lumbar. 


100 


A Branch,  rising  to  the  rectum,  so  large  as  at 
times  to  supply  the  place  of  the  hcemorrhoidal , and 
reach  to  the  bladder. 

Branches  sent  in  a radiated  form,  from  the  small  arch , 
and  distributed  to  the  neighbouring  muscles  and  mem- 
branes. 

II.  The  INTERNAL  ILIAC  Or  HYPOGASTRIC. 

Five  times  larger  in  the  foetus  than  the  exter- 
nal; but  after  a year,  only  equal  in  size  ; for 
while  the  umbilical  continues  pervious,  ex- 
hausting almost  the  whole  blood  of  the  trunk 
it  seems  continued  in  this  artery,  forming  an 
arch  that  is  convex  downwards,  and  from 
whose  circumference  the  other  small  arteries 
of  the  pelvis  are  sent  off.  About  to  pass  the 
brim  of  the  pelvis,  behind  the  peritoneum,  it 
lies,  with  a more  obtuse  angle,  in  the  middle 
between  the  ileum  and  sacrum  ; thence  bend- 
ing gradually  downwards  between  the  pelvis 
and  its  viscera.  When  the  umbilical  artery 
decays,  the  trunk  distributes  its  numerous 
branches  in  so  various  directions,  that  none 
of  them  seem  to  follow  its  course,  or  to  repre- 
sent its  continuation.  As  the  common  pudic 


101 


and  ischiadic , however  are  the  lowest,  and 
those  which  run  most  directly  downwards, 
they  have  generally  been  considered  by  ana- 
tomists as  the  terminating  branches.  - Its 
branches,  though  constant,  are  often  irregular 
in  their  origin ; sometimes  issuing  from  the 
trunk,  at  other  times  from  the  larger  branches. 

Of  these,  some  remain  within  the  pelvis,  and 
are  regularly  distributed  to  its  viscera ; while 
others,  emerging  from  the  pelvis,  run  to  its  external 
and  adjoining  parts. 

A.  The  ILEO-LUMBAR,  or  SMALL  ILIAC 

rising  from  the  posterior  part  of  the  trunk,  before 
or  after  the  sacro  laterals , bends  upwards,  and 
concealing  itself  near  the  crest  of  the  ileum,  be- 
tween the  psoas  and  internal  iliac  muscles,  sends 

Branches  to  the  psoas. 

An  Ascending  Branch — between  the  last  lumbar  verte- 
bra and  the  ileum. 

A Transverse  Branch — running  under  the  psoas,  to  the 
hollow  of  the  ileum. 

B.  The  sacro-l  ateral  arteries — irregu- 
lar in  origin  and  number.  Sometimes  only  one, 
sometimes  more,  even  to  five,  come  off  from  the 
trunk,  from  the  posterior  iliac , or  the  ileo-lumbar. 
If  only  one  be  present,  it  goes  down,  near  the 


102 


foramina  of  the  sacrum,  as  far  as  the  coccyx,  and 
there  forms  the  arch  already  mentioned.  If  more, 
the  superior  inosculate  among  themselves ; while 
the  inferior  terminates  in  the  sacro-median.  They 
always  give 

Anterior  Branches — running  to  the  bodies  of  the  verte- 
brae, inosculating  with  the  sacro  median  and  other  neigh- 
bouring arteries;  and  ramifying  on  the  adjoining  muscles 
and  nerves. 

Spinal  Branches — four  or  five  in  number,  each  of  them 
entering  the  sacral  holes,  and  distributed  to  the  spinal 
cavity. 

C.  The  umbilical  artery — which,  in  the 
foetus,  was  the  real  trunk  of  the  hypogastric,  re- 
flected upwards  to  the  umbilicus,  is,  in  the  adult, 
converted  almost  wholly  into  a soft  spungy  liga- 
ment, lying  in  the  folds  of  the  peritoneum.  A 
certain  portion  of  it,  however,  nearest  to  the  trunk, 
continues  open.  After  having  issued  from  the 
anterior  part  of  the  internal  iliac , it  runs  down, 
transversely  and  inwards,  to  the  lower  part  of  the 
bladder ; but  gradually  closes  as  it  is  reflected  on 
its  posterior  side.  The  ligamentous  part  which 
remains,  rises  still  higher  upon  the  sides  of  the 
bladder ; inclines  gradually  to  its  fellow  of  the  op- 
posite side,  and  at  last  is  inserted,  along  with  the 
urachas,  in  the  umbilicus.  The  portion  of  the 
artery  which  is  open  in  the  male,  sends  out 

The  Vesicals — two  or  three  in  number ; winding  upon 
the  inferior  middle  and  superior  part  of  the  bladder,  and 
inosculating  with  the  other  vesical  arteries. 


103 


Branches  to  the  ureters  and  vas  deferens,  anastomosing 
with  the  pudics. 

Hcemorrhoidal  Branches  to  the  lateral  parts  of  the 
rectum. 

In  the  female, 

Branches,  variously  distributed,  to  the  sides  of  the  blad- 
der, uterus,  and  vagina. 

A few  straight  branches  to  the  rectum. 

D.  The  inferior  vesical  arteries — va- 
rying in  number,  according  as  the  other  branches 
of  the  bladder  are  more  or  less  ramified  upon  it. 
One,  at  least,  is  always  present,  rising  often  from 
the  hypogastric , near  to  the  umbilical;  which, 
after  running  forwards  to  the  lower  part  of  the  blad- 
der towards  the  urethra,  sends  smaller  twigs  to  the 
rectum,  or  to  the  vagina  of  the  female.  This 
artery  is  larger  in  men  where  the  uterine  is  want- 
ing ; or  if  two  be  present,  either  both,  or  one  at 
least,  arises  from  the  middle  hcemorrhoidal.  The 
illustrious  Haller  has  observed  that  they  have 
sometimes  given  origin  to  the  pudic , ischiadic , and 
obturator. 

A branch  to  the  vesiculae  seminales,  vas  deferens,  and 
prostate  gland — running  up  between  the  bladder  and  rec- 
tum, and  inosculating  both  at  the  vesiculse  and  beyond  the 
prostate  gland,  with  the  prop undci  penis , or  deep  perineal, 
and  the  branch  from  the  opposite  side. 

A branch  going  to  the  bulb,  and  anastomosing  with 
branches  of  the  common  pudic. 


104 


E.  The  MIDDLE  HEMORRHOIDAL  ARTERY 

irregular  in  its  origin,  and  sometimes  wanting  ; but 
in  general,  rises  between  the  pudic  and  posterior 
iliac , or  the  pudic  itself.  After  various  flexions 
near  the  bladder  and  the  vagina,  it  attaches  itself  to 
the  rectum,  on  the  anterior  surface  of  which  it  runs 
as  far  as  its  sphincter  muscle.  Sometimes  it  is  so 
large  as  to  give  off  both  the  uterines  and  sacro- 
lateral.  In  men  it  gives, 

Numerous  branches,  winding  on  the  rectum  through  its 
whole  descent,  and  inosculating  often  with  the  mesenteric 
hcemorrhoidal  and  the  branches  of  the  opposite  side. 

Branches,  running  down  to  the  external  sphincter,  the 
levator,  and  the  skin,  and  anastomosing  freely  with  the 
external  hcemorrlioidals. 

Branches,  distributed  upon  the  bladder,  urethra,  semi, 
nal  vesicles,  and  prostate  gland,  as  the  artery  runs  between 
the  bladder  and  the  rectum.  If  the  middle  hcemorrhoidal 
only  send  branches  to  the  rectum,  these  sometimes  form  a 
single  trunk. 

In  women,  it  gives, . 

Intestinal  branches. 

Conspicuous  Branches,  distributed  to  the  vagina,  where 
it  lies  upon  the  rectum.  These  often  form  a particular 
vaginal  trunk. 

F.  The  uterine — a large  artery,  peculiar  to 
the  female.  It  issues,  in  such  a manner,  from  the 
hypogastric  trunk,  near  the  hcemorrhoidal  pudic,  or 
umbilical , as  to  have  often  the  appearance  of  being 
a branch  of  one  of  them.  Between  the  cervix 
uteri  and  the  bladder  it  touches  these  viscera  ; tra* 


105 


verses  the  sides  of  the  uterus,  and,  finally  winds 
upon  its  posterior  surface.  It  gives 

A Vesical  Branch — distributed,  often  double,  to  the 
bladder,  where  it  rests  upon  the  commencement  of  the 
vagina. 

A Descending  Branch — straight ; often  consisting  of 
many  twigs,  spreading  extensively  upon  the  vagina,  and 
sending  forwards  some  small  vesiculs.  If  many  vaginal 
branches  be  present,  they  here  inosculate  with  its  various 
twigs. 

An  Ascending  Branch — giving  out  numerous  serpentine 
branches,  running  between  the  outer  coat  of  the  Fallopian 
tube,  ovarium,  and  uterus.  These  inosculate  freely  with 
the  spcrmatics,  and  often  with  the  artery  of  the  opposite 
side. 

N.  B.  The  artery  frequently  rises  by  itself  from  the 
hypogastric , and  chiefly  from  the  middle  haemorrhoidal ; 
which,  under  the  name  of  vaginal , is  extensively  distri. 
buted  upon  the  vagina,  as  far  as  its  external  parts.  In 
that  case,  the  descending  branch  of  the  former  artery  is 
wanting ; and  some  twigs  of  this  one,  ascending  to  the 
cervix,  inosculate  with  the  uterine.  In  other  cases  the 
vaginal  branches  are  much  smaller  than  those  that  go  to 
the  uterus. 

G.  The  obturator  artery — rising  some- 
times from  the  epigastric  branch  of  the  external 
iliac , and  running  down  towards  the  pelvis  ; some- 
times and  indeed  more  frequently,  issuing  from 
the  trunk  of  the  hypogastric,  the  posterior  iliac, 
the  ischiadic , or  ileo-lumbar.  It  runs  downwards 
and  forwards,  connected  with  the  bones  of  the  pel  - 
vis,  by  cellular  membrane,  following  the  superior 
13 


106 


edge  of  the  obturator  interims;  and,  passing  through 
the  sinuous  depression  of  the  thyroid  hole,  runs 
to  the  thigh  with  its  concomitant  nerve  and  vein. 
In  the  pelvis,  it  gives 

Branches  to  the  glands  situated  among  the  iliac  vessels; 
but  which  are  often  wanting. 

Branches  to  the  levator  ani,  iliacus  internus,  psoas:  and 
bone — also  often  wanting. 

Branches  to  the  inferior  part  of  the  bladder,  rectum, 
seminal  vesicles,  and  prostate  gland,  inosculating  with  the 
pudic.  These  also  are  often  wanting,  though  at  times 
they  are  of  considerable  size,  and  divide  into  many  smaller 
branches,  running  as  far  as  the  corpora  cavernosa  penis. 

A Coronary  Branch — running  along  the  superior  and 
internal  margin  of  the  os  pubis  ; proceeding  under  the 
periosteum,  and  inosculating  with  its  fellow  of  the  oppo- 
site side.  From  this,  branches  ascend  to  the  abdominal 
muscles,  especially  the  recti,  and  to  certain  ramuli  of  the 
epigastric. 

Branches  shooting  out  to  the  obturator  internus,  in  its 
passage  through  the  thyroid  hole. 

Beyond  the  pelvis,  it  divides  into 

The  External  Branch — run  down  betwixt  the  two  obtu- 
rator muscles,  following  the  external  margin  of  the 
foramen,  and  bending  to  the  tuberosity  of  the  ischium  : 
afterwards  descending  to  the  back  part  of  the  thigh, 
between  the  acetabulum  and  tuberosity,  under  the  femoral 
quadratus.  Gives  out 

Branches  to  both  the  obturator  muscles,  and  to  the  cap- 
sule of  the  joint. 

A Deep  Branch — sinking  into  the  acetabulum,  and  dis- 
tributed to  the  inter-articular  fat,  the  round  ligament  of 
the  joint,  and  periosteum. 

A branch,  which,  after  inosculating  with  the  internal 
branch,  is  spent  upon  the  large  femoral  abductor. 


107 


A branch,  inosculating  and  forming  a coronary  plexus , 
near  the  tuberosity  of  the  ischium  with  the  internal 
branch. 

A branch,  distributed  to  the  posterior  part  of  the  cap- 
sule, the  periosteum  of  the  tuberosity,  the  abductor  mag- 
nus,  and  the  quadratus. 

Many  anastomotic  branches,  interwoven  with  the  de- 
scending branch  of  the  internal  circumflex  on  the  quadra- 
tus ; with  the  ischiadic  near  the  quadratus ; and  with  the 
external  hcemorrhoidals  of  the  pudic  at  the  tuberosity  of 
the  ischium. 

Branches — sometimes  wanting — distributed,  after  per- 
forating the  quadratus,  to  the  higher  extremity  of  the 
semitendinosus,  biceps,  semimembranosus,  and  surface  of 
the  tuberosity  of  the  ischium. 

The  internal  branch — running  first  backwards,  under 
the  obturator  externus  to  the  inner  margin  of  the  foramen, 
and  inosculating,  by  its  extreme  branches  beyond  that 
muscle,  with  the  branches  of  the  internal  circumflex. 
From  this  go 

Branches  to  the  obturator  muscles. 

A branch,  extending  beyond  the  obturator,  above  the 
adductor  brevis,  to  the  gracilis,  and  symphysis  pubis,  and 
disappearing  upon  the  skin  of  the  genitals.  This  branch 
inosculates  with  those  of  the  pudic. 

Branches,  distributed  to  the  capsule,  long  adductor,  and 
quadratus,  after  the  artery,  has  passed  the  obturator,  and 
inosculating,  on  the  triceps,  with  the  internal  circumflex. 

A branch,  forming  a coronary  arch  with  the  external 
branch  at  the  tuberosity  of  the  ischium.  From  this  are 
sent  twigs  to  the  adductor  magnus  and  biceps,  anastomos- 
ing with  the  common  pudic.  The  remaining  trunk,  which 
here  runs  into  the  circumflex , is  sent  to  the  quadratus,  and 
the  heads  of  the  abductor.  But  this  artery  is  throughout 
very  irregular. 


108 


H.  The  POSTERIOR  ILIAC,  Or  GLUTEAL 

the  largest  of  all  the  arteries,  issuing  from  the 
hypogastric.  It  rises  early  from  the  back  part  of 
the  trunk,  below  the  sacro-laterals  and  obturator  ; 
passes  deeply,  upwards  and  backwards,  to  the  su- 
perior edge  of  the  pyriform  muscle,  till,  concealed 
by  the  two  trunks  of  the  ischiadic  nerve,  it  leaves 
the  pelvis ; then  winding  externally  round  the 
pyriformis,  it  distributes  its  branches  among  the 
gluteal  muscles.  Within  the  pelvis,  it  sometimes 
gives  rise  to  the  ileo-lumbar , obturator , sacro  lat- 
erals, ischiadic , and  common  pudic.  Before  leav- 
ing the  pelvis,  it  gives 

1.  Branches  to  the  rectum;  though  often  wanting. 

2.  A Nutritious  Branch  to  the  ileum  and  internal  iliac 
muscle. 

3.  A branch,  ramified  on  the  pyriformis,  middle  and 
lesser  gluteus,  and  inosculating  with  the  ischiadic. 

On  leaving  the  pelvis,  or  soon  after,  the  trunk  is  divid- 
ed into 

The  Superficial  Branch — running  down  betwixt  the 
pyriformis,  and  middle  gluteus,  under  the  great  gluteus ; 
and  again  divided  into 

An  Ascending  Branch — bending  upwards  around  the 
margin  of  the  middle  gluteus,  and  distributing  its  ramuli, 
to  the  middle  gluteus,  the  superior  part  of  the  great  glu- 
teus, the  os  sacrum,  and  adjoining  part  of  the  ileum.  It 
inosculates  at  the  sacrum  with  the  posterior  sacrals.  and 
on  the  surface  of  the  ileum  with  the  deep  branch.  Some 
branches  perforate  the  gluteus,  and  become  cutaneous. 

A Descending  Branch — which  soon  ramifies — running 
between  the  middle  and  great  gluteus  ; then  to  the  great 


109 


gluteus;  •which,  having  perforated,  it  terminates  in  the 
skin. 

The  Deep  Branch — concealed  under  the  middle  gluteus, 
where  it  divides  into  two  branches. 

I.  The  ischiadic — smaller  than  the  former 
artery,  but  observing  the  same  course  with  the 
hypogastric.  It  passes  from  the  pelvis,  between 
the  lower  edge  of  the  pyriformis  and  the  levator 
ani,  and  descends  under  the  great  gluteus,  parallel 
with  the  larger  ischiadic  ligament.  I have  observed 
the  trunk  divided  into  two,  sending  off  the  middle 
hcemorrhoidal  and  pudic. — Within  the  pelvis,  it 
gives 

Many,  but  irregular,  branches  to  the  rectum,  uterus, 
bladder,  and  obturator  internus. 

Branches  to  the  pyramidalis,  inosculating,  at  the  pas- 
sage of  the  trunk,  outwards  with  the  pudic  branches. 

Without  the  pelvis, 

The  Coccygeal — concealed  by  that  portion  of  the  great 
gluteus  which  is  attached  to  the  sacrum,  coccyx,  and  the 
large  sacrc-sciatic  ligament,  and  running  under  this  liga- 
ment to  the  coccyx.  It  is  singularly  ramified,  and  gives 
origin  to 

Branches,  perforating  the  fibres  of  the  ligament  and 
great  gluteus,  running  to  the  coccygeus  and  fat  around 
the  levator. 

A Deep  Branch — distributed  to  the  coccygeus,  the 
bone,  and  the  levator  ani ; inosculating  with  the  pudic. 

Many  Anastomotic  Branches — forming  inosculations 
with  the  sacro. laterals  on  the  outer  side  of  the  sacral 
holes ; or,  passing  through  the  holes,  in  the  cavity  of  the 
pelvis. 

The  Concomitant  Ischiadic — first  approaching  the  great 
gluteus,  and  then  running  extensively  on  the  surface  of 


110 


the  nerve,  till,  at  last,  it  meets  with  similar  arteries,  aris- 
ing below  the  quadratus  from  the  internal  circumflex,  or 
the  first  perforant , with  which  it  inosculates. 

Branches,  anastomosing,  beyond  the  tuberosity  of  the 
ischium,  with  the  common  pudic  and  internal  circumfiex. 

A branch,  which  is  often  divided  a second  time,  bend- 
ing, downwards  and  forwards,  between  the  gemelli  and 
pyriformis,  to  the  trochanter,  distributing  its  twigs  to  the 
lesser  and  middle  gluteus,  obturator,  gemelli,  pyriformis, 
the  nerve,  the  quadratus,  trochanter,  articular  capsule, 
and  the  periosteum  of  the  acetabulum  Of  these,  some 
generally  inosculate,  beyond  the  pyriformis,  wiih  the  deep 
branch  of  the  posterior  iliac , and  still  deeper,  under  the 
muscle,  with  the  posterior  trochanteric  of  the  internal  cir- 
cumflex. Sometimes  a smaller  trunk,  sends  off  a few 
arteries  ; of  which  the  most  regular  and  constant  are  those 
which  lie  deep  and  anastomose. 

A Deep  Branch — running  down  before  the  obturator  to 
the  tuberosity'  of  the  ischium,  sending  twigs  to  the  tube- 
rosity and  its  muscles,  and  inosculating  with  pudic  and 
obturator. 

Gluteal  Branches — numerous — terminating  in  the  great 
gluteus  and  the  adjoining  adipose  substance.  These  ex- 
haust the  rest  of  the  trunk. 

K.  The  common  pudic — the  pudic — cir- 
cumflex, INTERNAL,  MIDDLE,  OF  EXTERNAL 
pudic — rising,  often,  from  a common  trunk,  with 
the  ischiadic , but  is  easily  distinguished  by  its 
smaller  size,  by  its  bending  more  forwards  and 
inwards  while  in  the  pelvis,  by  its  passing  out  be- 
tween the  pyriformis  and  the  posterior  part  of  the 
levator  ani,  and  by  it’s  greater  distance  from  that 
extremity  of  the  pyriformis  which  is  attached  to 
the  sacrum. 


Ill 


No  sooner  has  it  passed  from  the  cavity  of  the 
pelvis,  t an  it  is  concealed  by  the  great  sacro- 
sciatic  ligament,  under  which  it  runs  to  the  spine 
of  the  ischium,  and  enters  the  space  between  the 
lesser  and  greater  sacrosciatic  ligaments.  Having 
passed  the  spine,  it  next  runs  to  the  surface  of  the 
tuberosity  of  the  ischium  which  looks  inwards  to 
the  pelvis ; where,  being  attached  to  the  bone  by 
the  aponeurosis  of  the  obturator  interims,  and  fol- 
lowing the  curved  margin  of  the  ischium,  it  bends 
forwards  to  its  ramus.  The  artery  is  here  ex- 
hausted by  two  branches  sent  off  near  the  trans- 
verse muscle  of  the  perineum. 

Its  branches  form  three  classes. 

The  first , comprehending  those  arteries  which 
rise  from  the  trunk  as  it  descends  within  the 
pelvis,  viz. 

Small  branches  to  the  rectum  and  its  conglobate  glands. 

Vesical  Branches — to  the  lower  part  of  the  bladder; 
and  if  the  branch  be  large,  to  the  prostate  gland,  the 
seminal  vesicles,  or  the  vagina.  These,  as  well  as  the 
former,  are  often  w-anting. 

A branch  to  the  obturator  internus. 

The  second  class,  the  branches  issuing  from  the 
trunk  while  situated  between  the  two  ligaments, 
and  afterwards  traversing  the  curved  margin  of 
the  tuberosity  of  the  ischium.  These  are, 

Branches  passing  before  the  ligament  to  the  pyriformis 
and  great  gluteus. 

A branch  descending  beyond  the  gemelli  and  obturator, 


112 


and  inosculating  with  the  internal  circumflex  and  obtu- 
rator. It  is  often  wanting. 

A branch — running  transversely,  along  the  margin  of 
the  superior  gemellus,  to  the  trochanter  and  its  perios- 
teum ; sending  off  two  ramuli,  to  be  distributed  under  the 
obturator  internus  on  the  ischiadic  portion  of  the  aceta- 
bulum; others  inosculating  with  the  obturator  and  cir- 
cumflex ; and  still  others,  sinking  iuto  the  gemelli,  obtu- 
rator, and  trochanter.  This  branch  sometimes  rises  from 
the  ischiadic  as  was  mentioned. 

Branches  going  outwards,  in  the  course  of  the  artery, 
under  the  ligaments,  to  the  obturator,  the  periosteum  of 
the  tuberosity,  and  beyond  that  to  the  origin  of  the  semi- 
tendinosus  and  triceps  magnus.  These  also  generally 
inosculate  freely,  around  the  tuberosity  with  the  internal 
circumflex  and  the  obturator. 

Branches,  issuing  from  the  inner  side  of  the  artery; 
running  deep  to  the  coccyx,  and  iuosculating  with  the 
ischiadic  coccygeal. 

External  Hcemorrhoidal  Branches — a number  of  them 
spreading  inwards  on  the  levator  ani,  the  surrounding  fat 
and  the  sphincter.  Some  twigs  having  perforated  the 
levator,  reach  the  rectum,  and  inosculate  with  the  middle 
hcemorrhoidal. 

A branch,  rising  from  the  inner  margin  of  the  trunk, 
and  divided,  near  the  transverse  muscle,  to  the  sphincter, 
perineum  and  transversus  perinei. 

The  third  class  comprehends  those  branches 
issuing  from  the  trunk  as  it  bends  forwards,  with- 
out the  pelvis,  to  the  ramus  of  the  ischium.  Near 
to  the  transverse  muscle  of  the  perineum  the  pudic 
artery  divides,  and  sends  out 

The  Superflcial  Perineal — running,  in  men,  beyond 
the  transversus  perinei,  in  the  triangular  space  between 


113 


the  bulbo  cavernosus  or  accelerator  urinas,  and  ischio- 
cavernosus  or  erector  penis,  where  it  ascends  under  the 
skin,  or  between  the  muscular  fasciculi;  and  at  last  dis- 
appears, in  many  branches,  upon  the  surface  of  the  geni- 
tals— proceeding,  in  females  between  the  ischio-cavernosus, 
and  the  constrictor  cunni  or  vaginal  sphincter. 

The  Deep  Perineal , or  Deep  Artery  of  the  Penis  or 
Clitoris — in  males,  after  lying  deep  under  the  transversus 
perinei,  between  the  bulbo  cavernosus  and  the  ischio  caver- 
nosus, it  passes  upwards,  attached  by  cellular  membrane, 
to  the  bone,  between  the  ramus  of  the  ischium  and  pubis 
and  the  corpus  cavernosum ; at  last  reaching  the  synchon- 
drosis pubis  and  the  penis,  at  the  j unction  of  its  cavernous 
bodies,  is  there  divided.  In  females,  it  runs  between  the 
vaginal  sphincter,  the  erector  of  the  clitoris,  and  its  caver- 
nosus substance;  passing  afterwards  between  this  and  the 
os  ischium  and  pubis  to  the  body  of  the  clitoris. 

In  this  course  are  sent  otf  in  males, 

Two  large  branches  running  into  the  urethra  and  its 
cavernous  substance;  and  afterwards  to  the  penis. 

Smaller  branches,  rising  from  each  side  of  the  trunk ; 
going  to  the  ischio-cavernosus,  obturator  internus,  bulbo- 
cavernosus  the  crura  of  the  corpora  cavernosa,  Cowper’s 
glands,  and  the  prostate.  Those  which  run  to  the  pros- 
tate inosculate  with  the  inferior  vesicals. 

From  the  above  division  of  the  artery  proceed 
The  Dorsal  of  the  Penis — running  superficially  under 
the  integuments,  and  through  the  whole  length  of  the 
penis,  surrounding  it  behind  the  glands. 

The  Profunda , or  Deep  Branch  of  the  Penis— after 
anastomosing  with  its  fellow,  enters  the  corpus  caverno- 
sum of  its  own  side,  through  which  it  passes,  in  a straight 
line  to  its  other  extremity.  Many  of  its  branches  open 
into  the  cavernous  cells  of  the  penis;  some  into  the  caver- 
nous substance  of  the  urethra;  and  others,  after  perforat- 

14 


in g the  septum  of  the  penis  into  the  cells  of  the  opposite 
side.  Thus  are  the  cellular  parts  of  the  penis  distended 
with  blood  during  erection. 


III.  EXTERNAL  ILIAC  ARTERY. 

A single  arterial  trunk,  rising  from  the 
primitive  iliac  at  the  same  place  as  the  hypo- 
gastric supplies  the  whole  inferior  extremity 
with  vessels.  Commencing  under  the  name 
of  external  iliac,  it  successively  takes  the  ap- 
pellations of  inguinal,  femoral  and  popliteal. 

It  descends  obliquely  outward  along  the 
edge  of  the  psoas  muscle,  on  which  it  is  im- 
mediately placed.  This  muscle  also  bounds 
it  on  the  outside.  On  the  inside  and  a little 
behind  it,  lies  the  external  iliac  vein  ; in  the 
rest  of  its  course  it  ife  covered  by  the  perito- 
neum. When  it  approaches  the  crural  arch 
it  becomes  superficial,  being  placed  behind 
the  transversalis  muscle.  Here  it  is  some- 
times called  the  inguinal  artery,  and  becomes 
the  subject  of  an  operation  in  cases  of  aneu- 
rism in  the  groin. 


115 


The  place  at  which  this  vessel  should  take 
the  name  of  inguinal  artery  has  not  been 
precisely  determined  by  anatomical  writers: 
nor  has  the  artery  been  so  particularly  de- 
scribed as  its  importance  requires:  because  it 
was  not  suspected  that  the  surgeon  would 
ever  tie  this  great  blood  vessel,  within  the 
cavity  of  the  abdomen.  If  a straight  line  be 
drawn  from  the  superior  edge  of  the  symphysis 
of  the  pubis  to  the  superior  anterior  spinous 
process  of  the  ilium,  it  will  cross  the  great 
artery  just  as  it  rises,  to  become  superficial  on 
the  brim  of  the  pelvis.  This  then  we  shall 
consider  as  the  commencement  of  the  inguinal 
artery,  which  will  therefore  be  placed  between 
the  line  mentioned  above,  and  the  crural  arch, 
or  inferior  edge  of  the  external  oblique  muscle. 

The  superior  extremity  of  the  inguinal  ar- 
tery is  about  two  inches  in  distance  from  the 
crural  arch;  about  five  fingers  breadth  from 
the  superior  anterior  spinous  process  of  the 
ilium,  and  four  fingers  breadth  from  the  sym- 
physis pubis.  It  is  also  about  two  inches 
from  the  inside  of  the  anterior  parietes  of  the 


116 


abdomen,  that  is  from  the  inside  of  the  trans- 
versalis  muscle;  but  as  it  descends,  it  becomes 
gradually  more  superficial,  so  that  at  its  termi- 
nation in  the  femoral  artery,  it  is  in  contact 
with  the  inner  edge  of  the  crural  arch. 

On  its  outside,  lies  the  inner  edge  of  the 
psoas  muscle,  but  as  it  descends  it  gets  on  the 
fore  part  of  this  muscle. 

On  the  inside,  it  is  covered  by  the  perito- 
neum, descending  into  the  pelvis. 

On  the  fore  part,  is  the  peritoneum  which 
separates  it  from  the  intestines. 

Behind,  is  the  inguinal  vein,  which  gradu- 
ally gets  on  its  inside. 

It  is  covered  by  a lamina  of  membrane, 
thinner  than  that  which  invests  the  superficial 
arteries,  and  therefore  easily  separated.  In 
searching  for  this  artery  it  is  best  to  make  an 
incision  on  its  outer  edge,  between  the  vessel 
and  the  superior  spinous  process  of  the  ilium, 
as  otherwise  there  would  be  danger  of  pene- 
trating the  cavity  of  the  peritoneum;  but  pro- 
ceeding toward  the  artery  from  the  outside, 
this  membrane  is  easily  raised  from  its  ante- 
rior surface. 


117 


A.  The  epigastric — rising  by  an  acute  angle 
from  the  inner  side  of  the  trunk,  near  the  external 
lateral  margin  of  the  abdominal  ring  and  the  infe- 
rior part  of  the  Fallopian  ligament.  It  first  runs 
downwards ; then,  being  immediately  reflected, 
proceeds  inwards,  behind  the  internal  and  poste- 
rior surface  of  the  spermatic  cord  and  epigastric 
vein.  Now  rising  a little  higher,  and  resting  upon 
the  peritoneum  as  it  lines  the  abdominal  muscles, 
it  passes  the  outer  and  superior  commissure  of  the 
abdominal  ring,  and  then  proceeds  inwards,  under 
the  interior  part  of  the  transverse  muscle,  bending 
to  the  rectus,  behind  which  it  ascends  to  the  um- 
bilicus. It  at  last  divides  into  two  principal 
branches ; and,  in  this  course,  sends  off  in  the 
following  order, 

The  Funicular  Artery — rising  under  the  funiculus  or 
cord  ; passing  through  the  abdominal  ring,  and  dividing 
upon  the  cellular  substance  of  the  cord. 

N.  B.  In  females,  a branch  is  reflected  from  this  artery 
to  the  uterus,  accompanying  the  round  ligament,  and  inos- 
culating frequently  with  a branch  from  the  uterines  and 
the  spermatic.  Others  are  sent  through  the  ring,  winding 
upon  the  mons  veneris  and  the  labia. 

-Smaller  Branches,  issuing  separately  under  the  bend  of 
the  trunk  ; running  to  the  transverse  muscle,  the  posterior 
sheath,  and  inferior  muscular  part  of  the  rectum. 

Similar  branches — wandering  outwards,  in  the  course 
of  the  artery,  to  the  peritoneum  and  transversalis  • and 
through  that  to  the  obliques  and  the  skin. 

Several  more  conspicuous  branches,  and  more  deeply 
ramified — rising  in  various  places  from  the  trunk,  as  it 
passes  behind  the  rectus. 


118 


The  External  Branch — the  lesser  division  of  the  trunk 
commencing  below  the  umbilicus;  proceeding  outwards 
and  behind  the  external  margin  of  the  rectus,  and  running 
towards  the  ribs,  between  the  obliquus  internus  and 
transversalis ; inosculating,  in  this  course  with  the  exter- 
nal trunk  of  the  internal  mammary , the  musculo  phrenic 
and  the  lowest  intercostals. 

The  Internal  Branch — larger — running  obliquely  under 
the  rectus  to  the  umbilicus  ; and  dividing  into, 

A Subcutaneous  Branch — running  superficially  on  the 
internal  margin  of  the  rectus;  and,  whilst  it  inosculates 
with  the  twigs  of  the  opposite  side,  and  the  smaller  arte- 
ries of  the  mammary , runs  to  the  umbilicus,  and  winds  as 
high  as  the  ensiform  cartilage. 

B.  The  CIRCUMFLEX  ILIAC,  ABDOMINAL,  Or 
small  external  iliac — generally  smaller  than 
the  last,  and  sent  off  a little  lower  from  the  exter- 
nal side  of  the  trunk;  passes,  upwards  and  out- 
wards, in  a retrograde  course  under  the  peritoneum; 
reaches  the  crest  of  the  ileum ; and  bending, 
parallel  to  the  arched  circumference  of  this  bone 
to  the  highest  part  of  the  crest,  proceeds,  between 
the  extremity  of  the  illiacus  internus  and  transver- 
salis as  also  betwixt  the  transversalis  and  obliquus 
internus,  where  it  is  finally  expended  among  the 
abdominal  muscles.  From  this  arise, 

A branch  ramified  on  theiliacus  internus,  sartorius,  fat 
and  inguinal  glands. 

A branch  to  the  spermatic  cord  ; often  wanting. 

Branches,  running  from  various  places,  to  the  psoas, 
crural  nerve,  and  iliacus  internus ; inosculating  frequently 
with  the  transverse  branch  of  the  ileo-lumbar. 


119 


Four  branches,  or  sometimes  more,  of  which  the  exte.. 
rior  are  the  largest,  running  to  the  transversalis  and  obli. 
quus  internus;  and,  after  penetrating  this  muscle,  passing 
under  the  obliquus  externus,  with  many  branches  to  the 
anterior  part  of  the  abdomen,  inosculating  with  branches 
of  the  intercostal,  lumbar , and  mammary  arteries. 

A branch,  forming,  on  the  middle  of  the  crest,  a double 
anastonomosis  wifh  the  ileo-lumbar. 

An  Ultimate  Branch — exhausting  the  artery;  winding 
anteriorly  between  the  obliquus  and  transversalis.  As  it 
here  subdivides  into  branches,  rising  as  high  as  the  ribs,  it 
disappears  on  the  skin,  and  forms  a plexus  with  the  ad- 
joining vessels. 


FEMORA!  ARTERY. 

The  femoral  artery  commences  at  the  infe- 
rior edge  of  the  crural  arch,  about  the  middle 
of  the  space  which  separates  the  anterior  su- 
perior spinous  process  of  the  ilium  from  the 
spinous  process  of  the  pubis ; running  a little 
obliquely  to  the  anterior  and  internal  part  of 
the  thigh.  After  it  has  descended  about  two 
thirds  the  length  of  the  latter  it  enters  a ten- 
dinous ring  in  the  triceps  muscle  and  there 
takes  the  name  of  popliteal  artery.  The  fe- 
moral artery  therefore  extends  from  the  crural 
arch  to  the  lower  part  of  the  triceps  muscle. 


120 


Its  relations  to  the  neighbouring  parts  are  im- 
portant and  easy  to  be  known. 

On  its  fore  part,  the  femoral  artery  has  the 
fascia  lata  and  integuments,  which  cover  its 
upper  portion,  where  the  vessel  lies  in  a trian- 
gular space,  formed  by  the  crural  arch  above, 
the  sartorius  muscle  on  the  outside,  and  the 
middle  portion  of  the  triceps  muscle  and  the 
gracilis  muscle  on  the  inside.  It  is  however 
separated  from  the  integuments  and  fascia  by 
a great  quantity  of  fat  and  by  the  inguinal 
glands.  Lower  down,  its  fore  part  is  covered 
by  the  sartorius  muscle,  which  crosses  its 
course,  as  far  as  the  tendon  of  the  triceps 
muscle. 

On  the  back  part,  the  femoral  is  supported 
by  the  pectineus  muscle,  which  separates  it 
from  the  bone,  just  below  the  crural  arch. 
Lower  down,  the  pectineus  and  the  triceps 
muscles  lie  behind  it;  a great  quantity  of  fat 
separating  them  from  it. 

On  the  outside,  it  is  at  first  contiguous  to 
the  crural  nerve  and  the  psoas  and  iliac 
muscles;  low  down,  it  lies  against  the  inner 


121* 


part  of  the  crureus  muscle,  which  separates  it 
from  the  os  femoris. 

On  the  inside,  it  is  contiguous  to  the  femoral 
vein  and  corresponds  with  the  middle  portion 
of  the  triceps  muscle,  against  which  it  is  placed 
at  its  lower  part. 

The  femoral  artery  is  enclosed,  at  its  com- 
mencement, in  a strong  and  remarkable  sheath 
of  condensed  membrane,  which  encloses  it  with 
its  vein,  and  beginning  at  the  lower  edge  of 
the  crural  arch,  to  which  it  is  fixed,  runs  down 
the  thigh  and  gradually  loses  its  sheath-like 
form. 

It  appears  that  the  femoral  artery  is  near 
the  bones  in  two  places  only;  viz.  at  the 
crural  arch,  where  it  passes  over  the  pubis,  and 
at  the  inferior  part  of  the  thigh,  where  it  lies 
on  the  inside  of  the  thigh.  At  these  places 
therefore  alone  is  it  compressible. 

From  the  common  trunk  of  the  femoral,  generally  issue 
A.  Small  branches — passing  over  the  Fallopian  liga. 
ment,  and  running  extensively  upwards  to  the  skin  of 
the  abdomen. 

15 


122 


B.  Inguinal  branches — varying  in  number;  wander, 
ing  through  the  fat,  and  chiefly  distributed  to  the  inguinal 
glands. 

C.  A smaller  branch — which  immediately  divides 
into  ramuli,  running  outwards  and  transversely,  to  the 
upper  extremity  of  the  sartorius,  the  iliacus  intemus,  the 
crest  of  the  ileum,  the  broad  fascia,  and  the  middle  gluteus. 

D.  Minute  branches — terminating  in  iliacus,  psoas, 
and  pectineus;  inosculating  with  the  internal  circumflex 
branch,  and  sometimes  sinking  deep  among  the  muscles. 

E.  The  superior  external  pudic — running  upwards 
and  inwards,  above  the  genitals,  to  the  pubes,  where  it  is 
dispersed  upon  the  subcutaneous  fat  and  the  upper  part  of 
the  genitals. 

F.  The  middle  external  pudic — divided  into  many 
branches ; passing,  in  males,  transversely  and  inwards, 
above  the  pectineous  and  adductor  longus,  to  the  sides  of 
the  scrotum,  and  running,  subcutaneous,  along  the  penis 
to  the  praepuce:  but  in  females,  proceeding  to  the  labia 
and  the  praepuce  of  the  clitoris. 

G.  The  inferior  external  pudic — rising  often  from 
the  superficial  femoral  artery',  and  after  leaving  the  adduc- 
tor and  gracillis,  sinking  deep  into  the  scrotum  ; where  it 
inosculates  freely  with  the  superficial  perineal , the  hypo* 
gastric  scrotals,  the  former  branch,  and  with  branches  of 
the  obturator  and  internal  circumflex : sending  twigs,  also, 
to  the  gland  and  the  spermatic  cord,  or  the  labia. 

H.  A branch  to  the  sartorius  and  rectus,  often  accom- 
panying the  crural  nerve  deep  amongst  the  muscles. 

N.  B.  All  these  arteries  vary  often  in  number  and  dis- 
tribution, and  are  very  irregular  in  the  order  in  which 
they  are  sent  oft'. 

A.  Numerous  branches — irregular  in  dis- 
tance, order,  and  situation — rising  from  the  trunk 
as  it  runs  along  the  anterior  and  inner  part  of  the 


123 


thigh,  and  distributed  to  the  inguinal  glands  and 
sartorius,  and  through  this  to  the  skin ; also  to  the 
rectus,  vastus  internus,  long  and  short  adductors, 
and  gracilis.  Of  these,  some  are  larger,  some  less, 
entering  the  muscles,  in  different  places  from  three 
to  six. 

B.  The  LARGE  ANASTOMOTIC  BRANCH ris- 

ing from  the  inner  surface  of  the  trunk,  at  the  su- 
perior- margin  of  the  tendinous  canal ; and  bending 
downwards,  spreads,  with  many  serpentine  ramifi- 
cations, on  the  vastus  internus,  into  which  it  sinks. 
From  this  proceed, 

A Branch  to  the  sartorius  and  skin. 

A Branch — -running  to  the  outer  margin  of  the  tendon 
of  the  sartorius  before  the  trunk  reaches  the  vastus  inter, 
nus  ; and  passing,  along  with  the  tendon,  over  the  joint 
of  the  knee,  disappears  on  the  fascia  and  skin  of  the  leg. 
It  first,  however,  gives  many  branches  to  the  knee,  inos- 
culating with  the  inferior  articulars , and  with  the  recur- 
rent branch  of  the  anterior  tibial.  Like  the  following 
artery,  it  often  rises  separately  from  the  femoral  trunk. 

A Branch — rising  in  the  tendinous  canal,  and  accom- 
panying the  tendon  of  the  triceps  which  covers  it,  to  the 
inner  condyle  of  the  femur,  running  downwards,  it  spreads 
into  various  ramifications.  It  also  sends  off  a branch  un- 
der the  tendon,  as  it  is  attached  to  the  condyle,  which  runs 
transversely  upon  the  periosteum  of  the  condyle,  to  the 
common  tendon  of  the  extensors  and  the  external  condyle, 
where  it  forms  an  arch,  around  this  extremity  of  the  femur, 
with  the  superior  and  inferior  externo-articulurs , and  also 
distributes  twigs  to  the  carity  of  the  joint. 


124 


A Branch — running  transversely,  perforating  the  vas- 
tus near  the  rectus,  and  inosculating  on  the  substance  of 
this  last  muscle,  with  a branch  of  the  external  circumflex. 

A Branch — rising  in  a similar  manner  from  the  vastus, 
and  inosculating  on  the  surface  of  the  knee,  with  the  arti- 
cular branches. 

A Branch — passing  upwards,  anastomosing,  upon  the 
vastus  or  cruralis,  with  the  small  descending  branch  of 
the  circumflex. 

\ 

C.  The  superior  perforant — issuing  from 
the  outer  side  of  the  trunk,  where  it  lies  concealed 
by  the  tendon  of  the  triceps,  and  bending  trans- 
versely backwards,  between  the  posterior  surface 
of  the  bone  and  the  inferior  muscular  part  of  the 
great  adductor,  near  the  origin  of  the  short  head  of 
the  biceps,  penetrates  the  fibres  of  this  muscle,  or 
those  of  the  adductor,  to  the  flexors  of  the  thigh — 
Sending  off  in  this  course, 


Branches  to  the  adjacent  muscles. 

A Perforating  Branch — which  soon  ramifying,  inoscu- 
lates in  the  substance,  or  on  the  surface  of  the  flexors, 
with  ascending  and  descending  twigs,  but  chiefly  on  the 
long  head  of  the  biceps  with  descending  branches  of  the 
second  perforant , and  with  ascending  branches  of  the 
inferior  perforant. 

N.B.  The  perforating  branch  of  this  and  the  following 
artery  is  sometimes  wanting  ; and  the  trunk  is  inflected 
under  the  biceps  only  to  the  vastus  extemus,  where  it 
passes  into  many  branches,  inosculating  variously  with 
the  neighbouring  articular  artery. 


125 


D.  The  INFERIOR  PERFORANT issuing  a 

little  below  the  last,  from  the  external  margin  of 
the  trunk  ; running  transversely,  under  the  adduc. 
tor  magnus,  at  the  posterior  surface  of  the  femur, 
to  the  short  head  of  the  biceps,  and  under  that  to 
the  muscular  substance  of  the  vastus  externus. 
It  sometimes  extends  to  the  cruralis,  and  is  often 
double.  It  gives 

Minute  branches  to  the  adjacent  muscles. 

The  Inferior  Nutritious  Branch — sent  upwards  from 
the  trunk,  as  it  passes  under  the  short  head  of  the  biceps  ; 
inosculating,  on  the  femur,  near  the  linea  aspera,  with  the 
superior  nutritious  branch,  and  distributing  its  last  ramuli 
in  the  substance  of  the  bone.  It  is  sometimes  sent  otf  from 
the  former  perforant. 

A Perforating  Branch — running  in  the  hollow  of  the 
poples,  to  the  semimembranosus,  and  inosculating,  on  its 
surface,  with  the  superior  perforant.  It  is  sometimes 
wanting. 

Branches— uniting,  on  the  vastus  externus,  with  the 
larger  and  lesser  descending  branches  of  the  external  cir. 
cumflex. 

A Branch — bending  to  the  vastus  internus,  and  some- 
times inosculating  under  the  tendon  of  the  triceps,  with  a 
lesser  descending  branch . 


THE  PROFUNDA  OR  DEET  FEMORAL  ARTERY. 


This  vessel  arises  from  the  femoral,  about 
an  inch  and  a half  below  the  crural  arch.  It  is 
concealed  at  its  origin,  by  the  femoral,  the 
glands,  and  a quantity  of  fat,  and  lies  in  the 
deep  triangular  cavity,  between  the  iliacus, 
pectineus,  and  adductors ; bending  with  a 
flexure,  convex  outwardly,  over  the  united 
iliacus  and  psoas,  it  runs  backwards  and  down- 
wards, to  the  higher  extremity  of  the  vastus 

internus.  As  it  reaches  the  bottom  of  this 
cavity,  it  again  bends  gently  forwards;  and 
passing  between  the  long  and  short  adductors 
and  the  vastus  internus,  runs  downwards  and 
backwards,  near  to  the  middle  of  the  femur. 
At  last,  entering  the  space  between  the  long 
and  short  adductors,  or  perforating  this  last 
muscle,  it  reaches  the  adductor  magnus,  and 
passes  through  it.  with  various  branches,  run- 
ning among  the  posterior  muscles  of  the  thigh. 
The  first  direction  and  size  of  the  trunk  varies 
considerably,  according  as  it  issues,  sooner  or 


127 


later,  from  the  common  femoral , and  according 
to  the  number  and  size  of  the  branches  which 
it  sends  off.  Of  these,  some  are  of  little  con- 
sequence; but  four  of  the  following  merit  at- 
tention. 

Many  small  branches — some  of  which  are  often  want- 
ing; rising  either  separately,  or  forming  together  a com- 
mon trunk — distributed  in  various  places,  to  the  iliacus 
internus,  capsule,  skin,  sartorius,  vastus  externus  and 
internus,  and  the  heads  of  the  triceps;  and  inosculating, 
on  these  muscles,  with  small  twigs  of  the  internal  and 
external  circumflex.  At  times  they  send  off  some  internal 
puclic  branches. 

A.  The  EXTERNAL  CIRCUMFLEX R COIlSpi- 

cuous  branch,  and  often  the  first  when  it  arises 
from  the  common  trunk;  though  it  sometimes 
issues  from  the  superficial  femoral.  It  bends 
outwards,  between  the  iliacus  internus,  the  rectus 
and  sartorius,  and  between  the  tensor  of  the  broad 
fascia  and  the  anterior  surface  of  the  middle  glu- 
teus; and  passing  transversely  under  the  tendinous 
head  of  the  rectus  externus,  disappears  at  last  near 
the  root  of  the  large  trochanter.  In  this  course  its 
principal  divisions  are, 

A branch,  sinking  in  the  iliacus  internus,  and  return- 
ing to  the  cavity  of  the  pelvis. 

Another  branch,  extending  under  the  iliacus,  to  the  in- 
ner side  of  the  femur  ; inosculating  near  the  trochanter 
minor,  with  a branch  of  the  internal  circumflex. 


128 


The  Large  Transverse  Branch — constituting  the  supe- 
rior part  of  the  trunk,  where  it  lies  under  the  vastus ; and 
giving  out,  near  to  its  origin, 

Branches  to  the  iliacus,  tensor  of  the  broad  fascia, 
and  the  higher  extremity  of  the  fartorius  and  rectus. 

Many  branches,  rising  from  the  anterior  part  of  the 
trunk,  bending  upwards  and  outwards,  and  termma’ing, 
in  various  ramifications,  on  the  tensor  of  the  broad  fascia, 
the  middle  gluteus,  and  sometimes  on  the  anterior  and 
lower  portion  of  the  great  gluteus. 

A Branch,  winding  outwards  between  the  iliacus  and 
lesser  gluteus,  and  spreading  on  the  external  surface  of  the 
pelvis,  where  it  inosculates  with  the  profundissima,  or 
deeper  branch  of  the  ileum. 

The  Anterior  Trochanteric  Branch — of  small  size 
(sometimes  very  small) — lying  between  the  iliacus  inter- 
nus  and  the  anterior  margin  of  the  vastus  externus.  It 
runs  under  the  middle  and  lesser  gluteus,  on  the  anterior 
part  of  the  trochanter  major,  where,  concealed  by  a quan- 
tity of  fat,  and  terminating  in  the  trochanteric  fossa,  it 
inosculates  with  the  posterior  trochanteric , after  sending 
branches  to  the  aforesaid  muscles,  the  bones,  and  the  cap- 
sule. 

Two  or  three  large  Transverse  Branches — the  last  ra- 
mifications of  the  trunk — covered  by  the  vastus  externus  ; 
w inding  round  the  root  to  the  back  part  of  the  trochanter, 
and  anastomosing,  upon  the  tendon  of  the  greater  gluteus, 
or  beyond  it  near  the  bone,  with  the  transverse  branch  of 
the  first  per  for  ant  and  the  descending  branch  of  theposfe- 
rior  trochanteric. 

The  Large  Descending  Branch — risiug  from  the  trunk, 
where  it  seems  continued  into  the  great  transverse  branch 
already  mentioned,  it  winds  under  the  rectus  to  the  ante- 
rior margin  of  the  vastus.  In  its  course  to  the  patella,  it 
is  covered,  near  the  cruralis,  by  the  margin  of  the  vastus 
externus;  sending  branches  to  the  latter,  but  not  to  the 


129 


former.  A little  above  the  kuee,  and  near  the  patella,  it 
approaches  so  near  the  surface,  that  its  last  inosculation 
with  the  external  articular  is  frequently  seen  through  the 
substance  of  the  muscle. 

The  Small  Descending  Branch — rising  sometimes  from 
the  superficial,  sometimes  from  the  large  transverse  branch 
of  the  circumjlex : first  sending  twigs  under  the  rectus,  to 
the  sartorius  and  vastus  internus ; then  winding  inwards 
through  the  substance  of  this  muscle,  inosculates  at  last, 
under  the  tendon  of  the  triceps,  with  the  inferior  perfo - 
rant  of  the  superficial  femoral,  or  more  frequently,  with 
the  large  anastomotic.  I hare  observed  it,  at  other  times, 
pass  outwards  to  the  cruralis  and  vastus  externus. 

B.  The  internal  circumflex — rises,  near 
the  origin  of  the  external  circumjlex , from  the  in- 
ternal and  posterior  part  of  the  trunk ; passes  to 
the  anterior  and  middle  part  of  the  pectineus 
through  the  adipose  substance  between  this  mus- 
cle and  the  tendon  of  the  psoas,  and  runs  deeply 
and  transversely  backwards,  above  the  trochanter 
minor.  Concealed  here  by  muscles  and  fat,  it 
divides  into  branches,  between  the  short  and  great 
adductor,  or  between  the  adductor  and  pectineus. 
Of  these  branches,  the  largest,  considered  as  the 
trunk,  approaches  the  neck  of  the  femur,  acetabu- 
lum, and  obturator  externus  and  proceeding  out- 
wards and  backwards  to  the  interstice  between 
the  quadratus  and  adductor  magnus,  divides  into 
two  branches,  and  is  partly  expended  on  the 
muscles  attached  to  the  femur,  and  partly  through 
the  interstice  to  the  flexors  of  the  thigh.  Thus 
are  produced  in  the  following  order, 

16 


130 


Branches  to  the  iliacus  Interims,  psoas,  pectineus  and 

capsule. 

Transverse  branches  to  the  pectineus,  long  and  short  ad. 
ductor,  and  gracilis,  interwoven  every  where  upon  their 
surface,  with  branches  of  the  superficial  femoral  and  exter- 
nal circumflex-,  and  more  deeply  with  twigs  of  the  obtu- 
rator ; inosculating  also,  with  puclic  branches  by  a less 
obvious  twig,  running  behind  the  gracilis  to  the  penis. 

All  these  branches  are  generally  sent  off  before  the  trunk 
is  concealed  by  the  pectineus. 

Many  branches,  rising  separately  while  the  trunk  passes 
under  the  head  of  the  femur,  between  the  trochanter  mi- 
nor and  the  acetabulum ; distributed  to  the  head  of  the 
triceps,  pectineus  and  capsule,  and  inosculating  frequently 
with  other  branches  of  the  deep  femoral  or  profunda. 

The  Superior  Branch,  or  Superior  Anterior  Ascend- 
ing— of  greater  size,  seemingly  one  half  of  the  trunk — 
runs  transversely  between  the  short  and  great  adductors, 
towards  the  symphysis  pubis,  sometimes  disappearing  there 
upon  the  skin — sends 

The  rest  of  the  arfery,  after  distributing,  in  this  course 
various  branches  to  the  adductor,  gracilis,  and  genital 
integuments,  inosculates  with  the  internal pudics. 

The  Inferior  Branch,  or  Inferior  Posterior  Circumflex 
— exhibiting  a continuation  of  the  trunk — runs,  over  the 
lesser  trochanter  to  the  neck  of  the  femur;  distributing, 
in  its  course  small  branches  to  the  capsule  of  the  joint, 
the  acetabulum,  obturator,  and  great  adductor. 

C.  The  first  perforant — running  back- 
wards from  the  trunk,  below  the  small  trochanter ; 
and  between  the  pectineus  and  short  adductor,  or 
between  its  fibres,  proceeds,  near  the  vastus  inter- 
ims in  such  a manner  as  to  pass  obliquely  out- 
wards, between  the  femur  and  that  part  of  the  great 


131 


adductor  which  is  attached  to  the  bone.  About 
an  inch  from  the  great  trochanter,  it  perforates  the 
adductor  in  two  places,  under  the  covering  of  the 
great  gluteus  ; to  which,  along  with  the  flexors, 
it  distributes  its  ultimate  branches.  From  this 
arise, 

Large  branches — sometimes  rising  separately  from  the 
deep  femoral — exhausting  themselves  upon  the  vastus  in- 
ternus  and  the  short  and  great  adductors. 

Branches,  spreading  out  from  the  concealed  trunk  to 
the  adductor,  quadratus,  and  trochanter. 

An  Ascending  Branch — forming,  above  the  superior 
extremity  of  the  great  adductor,  an  elegant  inosculation 
with  the  descending  branch  of  the  posterior  trochanteric. 

A Large  Transverse  Branch — sometimes  double — run- 
ning, under  the  abductor,  to  the  gluteus;  and  after  perfo- 
rating the  tendon  of  this  muscle,  proceeding  outwards, 
round  the  root  of  the  trochanter,  to  the  vastus  externus, 
where  it  inosculates  with  the  large  transverse  branch  of 
the  external  circumflex. 

A Branch — often  double — rising,  as  it  were,  from  the 
former;  passing  through  the  adductor  to  the  great  gluteus, 
and  there  dividing  into  various  branches  inosculating  with 
the  gluteal  branches  of  the  ischiadic. 

A Nutritious  Branch — running  down  upon  the  surface 
of  the  bone,  and  anastomosing  with  a nutritious  branch 
of  the  second  perforant. 

A Descending  Perforant — passing  through  the  great 
adductor,  and  running  extensively  on  the  inner  surface  of 
the  flexor  muscles.  As  it  here  divides  into  many  branches, 
spreading  outwards  and  inwards,  it  distributes  several  to 
each  of  the  flexors  and  the  great  adductor,  and  forms  many 
superficial  and  deep  communications  on  these  muscles  with 
the  internal  branch  of  the  inferior  circumflex , with  some 


132 


recurrent  branches  of  the  second,  perforant , and  sometime?, 
though  more  rarely,  with  twigs  of  the  superior  perforant 
rising  from  the  superficial . These  elegant  inosculations 
are  more  frequently  observed  upon  the  semimembranosus, 
adductor,  biceps,  and  on  the  nerve. 

D.  The  sec  ond  pereorant — exhibiting  a 
continuation  of  the  trunk — passes  sometimes  sin- 
gle, and  at  others  double,  through  the  small  space 
between  the  long  and  short  adductor,  or  through 
the  long  adductor  itself ; then  proceeding  obliquely 
outwards  and  downwards,  between  the  femur  and 
the  great  adductor,  and  penetrating  the  adductor 
near  the  linea  aspera,  at  the  middle  of  the  thigh, 
and  inner  side  of  the  short  head  of  the  biceps,  is 
exhausted,  like  the  last  artery  among  the  flexor 
muscles  by  a descending  perforant  branch.  To 
this  artery  are  referred, 

Large  branches — sinking  into  the  vastus  internus  and 
long  adductor,  before  the  immersion  of  the  trunk. 

Another  Branch,  partly  distributed  to  the  vastus,  partly 
entering  the  bone  by  two  twigs,  and  inosculating  with 
the  large  nutritious  artery. 

A Large  Branch — often  double — entering,  like  the 
trunk,  the  long  adductor,  but  higher,  terminating  in  the 
substance  of  the  adductor,  or,  as  sometimes  happens, 
sending  an  artery  through  the  belly  to  the  muscle  of  the 
flexors. 

An  Ascending  Branch — inosculating,  near  the  trochan. 
ter,  upon  the  back  part  of  the  bone,  with  the  first  per. 
for  ant. 

A Superior  Transverse  Branch — running,  either  trans. 
versely  or  obliquely,  a little  below  the  tendon  of  the  great 


133 


gluteus,  between  this  muscle  and  the  femur,  to  the  sub- 
stance of  the  vastus  externus,  and  anastomosing  with  the 
transverse  branches  of  the  large  descending  branch  of  the 
external  circumflex.  Before  the  trunk  sinks  in  the  vastus, 
a branch  sometimes  rising  suddenly  from  this  one,  beyond 
the  great  adductor,  distributed  to  the  external  flexors,  and 
known  by  the  name  of  the  third  per  for  ant. 

An  Inferior  Transverse  Branch — running  in  the  same 
direction  as  the  last;  and  about  two  or  three  inches  below 
the  tendon  of  the  great  gluteus,  passes,  under  the  short 
head  of  the  biceps  to  the  vastus  externus.  If  the  artery- 
proceeds  farther,  it  gives  rise,  like  the  last,  to  a fourth 
perforant.  It  gives 

Many  branches,  winding  on  the  adductor. 

The  Large  Nutritious  Branch  of  the  Femur — running 
down,  near  the  short  head  of  the  biceps,  to  the  outer  side  of 
the  linea  aspera  ; inosculating  with  a small  inferior  nutri- 
tious branch  from  the  inferior  perforant  of  the  superficial 
femoral , and  penetrating  the  bone  with  a larger  external 
branch.  This  artery  is  irregular  both  in  origin  and  di- 
rection. 

A branch,  concealed  in  the  substance  of  the  biceps. 

Branches,  meeting  the  descending  branch  of  the  cir- 
cumflex on  the  vastus  externus,  and  sometimes  the  supe- 
rior externo  articular , with  a large  twig.  They  appear 
to  rise  from  the  nutritious  branch  in  such  a manner,  that 
it  seems  to  be  inflected  through  the  short  head  of  the  biceps 
to  the  vastus  externus. 

Many  branches  distributed  to  the  short  head  of  the 
biceps. 

A Descending  Perforant — passing  under  the  flexors 
after  perforating  the  adductor,  and  transmitting  ramuli  to 
the  external  and  internal  flexors.  It  forms,  upon  the  sur- 
face and  substance  of  these  muscles,  inosculations  upwards 
with  this  artery,  and  downwards  with  the  perforant  of  the 
superficial. 


THE  POPLITEAX  ATITEEY. 


That  part  of  the  superficial  femoral  which 
runs  along  the  hollow  of  the  poples.  As  its 
limits  should  be  accurately  defined,  on  account 
of  the  numerous  branches  which  arise  from 
it,  we  observe  that  its  superior  part  is  bound- 
ed by  the  posterior  margin  of  the  tendon  of 
the  triceps,  and  its  inferior  by  the  higher  ex- 
tremity of  the  soleus  muscle,  under  which  it 
divides  into  the  anterior  and  posterior  tibial 
arteries.  Being  covered  externally  by  the 
aponeurosis  which  surrounds  the  joint,  it  runs 
obliquely,  outwards  and  downwards,  through 
the  adipose  substance  between  the  flexor  ten- 
dons, passing  into  the  cavity  between  the  con- 
dyles and  the  heads  of  the  gastrocnemii.  As 
it  proceeds  over  the  joint  of  the  knee,  it  lies 
upon  the  capsule,  and  afterwards  on  the  popli- 
teal muscle.  The  numerous  branches  to 
which,  in  this  course,  it  gives  origin,  are  divid- 
ed into  articular  and  muscular . Of  these,  the 
first  are, 


% 


135 


A.  The  superior  externo-articular — 
ascending,  on  the  periosteum  of  the  femur,  from 
the  outer  side  of  the  trunk,  above  the  condyle, 
and  running,  on  the  periosteum,  towards  the 
origin  of  the  short  head  of  the  biceps ; then 
bending,  under  the  common  tendon  of  the  biceps, 
to  the  posterior  margin  of  the  vastus  interims, 
divides  into  two  ramuli. 

Many  Branches  of  smaller  size,  running  upwards  and 
downwards,  distributed  to  the  periosteum,  capsule,  biceps, 
and  gastrocnemii. 

The  Deep  Branch,  passing  through  the  vastus  muscle, 
which  it  supplies  with  ramuli,  to  the  periosteum  of  the 
external  condyle,  and  there  spreading  into  various  ramifi- 
cations. Of  these  some  are  distributed  to  the  lateral  liga- 
ment and  skin  ; some  are  interwoven  with  the  inferior 
exlerno. articular , and  the  perforating  branches  of  the 
superficial  femoral ; while  others  run  transversely  to  the 
internal  condyle,  and  inosculate  with  the  superior  interno- 
articular. 

The  Superficial  Branch — winding  on  the  surface  of  the 
vastus  externus,  near  its  extremity,  towards  the  upper 
edge  of  the  patella,  and  anastomosing  by  an  ascending 
branch  with  the  extremity  of  the  large  descending  branch 
of  the  circumflex , under  the  tendon  of  the  rectus,  with  a 
branch  of  the  large  anastomotic  ; winding  also  round  the 
patella,  and  uniting,  by  various  descending  twigs  with  the 
vascular  plexus  of  the  knee,  formed  by  all  the  articular  s 
together. 

B.  The  SUPERIOR  INTERNAL  ARTICULAR 

running,  above  the  inner  condyle,  from  the  inte- 
rior edge  of  the  trunk,  in  a transverse  or  oblique 


136 


# 


direction,  under  the  tendon  of  the  triceps  to  the 
patella.  It  is  sometimes  double. 

Smaller  branches — distributed  in  the  hollow  of  the 
poples,  to  the  periosteum,  capsule,  condyle,  and  flexor 
tendons. 

A Superficial  Branch — exhibiting  a continuation  of  the 
trunk — running  between  the  tendon  of  the  biceps  and  the 
vastus  internus,  to  the  surface  of  the  knee,  and  there 
forming  a vascular  plexus  by  its  numerous  branches.  It 
inosculates,  near  the  lateral  ligament,  with  an  ascending 
branch  of  the  inferior  inter  no-articular,  and,  by  sending 
out  branches  that  obliquely  perforate  the  ligamentous 
strata,  is  extensively  ramified  below  the  patella. 

N.B.  A Deep  Branch  arises  from  the  large  anasto- 
motic  branch  of  the  femoral. 

C.  The  MIDDLE  ARTICULAR,  Or  AZYGOS 

irregular  in  its  origin — rising  sometimes  from  the 
posterior  and  outer  surface  of  the  popliteal , at  other 
times  from  the  external  or  internal  superior  articu- 
lar; runs  always  to  the  posterior  ligaments  of  the 
knee,  and  the  middle  of  the  capsule ; and  divides 
into 

An  External  Brauch — winding  extensively  between 
the  condyles  ; running  to  the  posterior  and  crucial  liga- 
ment, and  the  semilunar  cartilages,  and  inosculating  here 
with  all  the  adjoining  branches. 

An  Internal  Branch — distributing  its  twigs  in  the  inner 
side  of  the  capsule,  to  the  fat  of  the  poples,  to  the  bone, 
crucial  ligament,  and  capsule. 


137 


D.  The  INFERIOR  EXTERNO-ARTICULAR 

rising  below  the  knee  joint  under  the  plantaris 
and  external  head  of  the  gastrocnemius  ; runs 
outwards  and  upwards  to  the  top  of  the  fibula,  and 
there  entering  under  the  external  lateral  ligament 
and  aponeurosis,  a groove  which  is  formed  in  the 
external  semilunar  cartilage,  proceeds  between  the 
femur  and  the  head  of  the  fibula,  to  the  patella. 

« 

Separate  branches — distributed  to  the  popliteus,  soleus, 
gastrocnemius,  skin,  and  periosteum. 

A Branch,  forming  a conspicuous  inosculation  with  the 
tibial  recurrent. 

A Superficial  Branch — sent  off  while  the  trunk  rests 
upon  the  cartilage ; transmitting  many  small  ramuli  to  the 
vascular  plexus  of  the  knee,  the  aponeurosis  and  skin ; 
aud  inosculating  with  the  superior  externo-articular. 

Small  Branches — entering  the  semilunar  cartilage,  peri- 
osteum, and  capsule. 

A Deep  Branch — entering  the  capsule  near  the  patella, 
and  spreading  out  its  various  ramifications  within  the 
cavity  of  the  joint. 

E.  The  INFERIOR  INTERNO  ARTICULAR 

descending  a little,  as  it  runs  inwards  below  the 
joint,  between  the  superior  edge  of  the  popliteus 
and  the  gastrocnemius,  to  the  posterior  angle  of 
the  condyle  of  the  tibia ; and  then  passing,  under 
the  internal  lateral  ligament  of  the  knee,  and  the 
tendons  of  the  internal  flexors  to  the  lower  margin 
of  the  patella. 

Many  branches — terminating  in  the  popliteus,  posterior 
and  crucial  ligaments,  capsule  and  tendons  of  the  flexors  ; 

17 


138 


one  of  them  inosculating  with  the  nutritious  branch  of  the 
posterior  tibial. 

Superficial  Branches — dispersed  on  the  aponeurosis,  to 
the  inferior  edge  of  the  patella,  and  communicating  there 
with  the  anterior  tibial. 

Branches  exhausted  on  the  common  tendon  of  the  exten- 
sors and  ligament  of  the  patella. 

Branches  to  the  ligament  of  the  patella,  inosculating 
with  the  superior  and  inferior  exter no-articular . 

A Deep  Branch — running  along  the  edge  of  the  internal 
semilunar  cartilage,  and  inosculating,  by  a transverse 
branch,  in  the  hollow  of  the  joint,  under  the  patella,  with 
the  inferior  externo.articular. 

N.  B.  The  vascular  plexus,  covering  the  knee,  is  form- 
ed by  all  the  articular  arteries,  the  recurrent  tibial , cir- 
cumflex.> large  anastomotic , and  some  twigs  of  the  perfo- 
rants. 

F.  Of  the  muscular  branches,  which  are 
infinitely  varied,  the  following  chiefly  merit  atten- 
tion. 

Two  or  three  Conspicuous  Branches — though  often 
wanting — distributed  to  the  flexors,  but  chiefly  to  the 
semimembranosus,  biceps,  and  nerve.  These  sometimes 
supply,  by  reflex  branches,  the  want  of  perforants  from 
the  superficial  femoral. 

Two  Gastrocnemial  Branches — running,  in  parallel 
lines,  between  the  heads  of  the  gastrocnemius,  and  pene- 
trating, with  various  ramifications,  the  internal  side  of 
the  muscle,  in  which  they  terminate.  Of  these  one  runs 
on  the  surface  of  the  muscle,  to  the  tendo  Achilles,  and  its 
insertion  into  the  os  calcis. 

Two  branches  to  the  soleus,  but  sometimes  wanting. 

Branches  to  the  substance  of  the  plantaris,  periosteum, 
vessels,  and  nerves. 


139 


THE  ANTERIOR  TIBIAE  ARTERY. 

Somewhat  smaller  than  \ht  posterior — rises 
anteriorly  from  the  popliteal , at  the  inferior 
margin  of  the  popliteal  muscle,  and  perforat- 
ing the  interosseous  ligament,  runs  from  the 
posterior  to  the  anterior  part  of  the  leg.  It 
here  descends  close  to  the  ligament,  at  first 
between  the  tibialis  anticus  and  common  ex- 
tensor, and  then  between  the  anticus  and  the 
extensor  longus  of  the  great  toe.  In  this 
course,  it  lies  nearer  to  the  fibula  than  the 
tibia  ; but  having  gradually  separated  from 
the  ligament,  it  turns  now  more  forwards  and 
inwards  the  farther  it  descends  ; and  passing 
over  the  lower  extremity  of  the  tibia,  and  over 
the  tarsus,  along  with  the  extensor  tendons, 
under  the  crucial  ligament,  divides,  between 
the  first  and  second  metatarsal  bones  into  two 
branches  : of  which  one  sinking  between  the 
bones  to  the  planta  of  the  foot,  inosculates  with 
the  external  and  internal  plantar  branches  of 
the  posterior  tibial , while  the  other,  passing 


140 


along  the  dorsum  of  the  foot,  runs  to  the 
great  toe.  The  most  remarkable  branches 
issuing  from  it  in  this  course,  are, 

A.  A branch  to  the  origin  of  the  posterior 
tibial  muscle,  or  soleus. 

B.  An  a sc  ending  branch — transmitting 
twigs  under  the  popliteus  to  the  external  and  pos- 
terior part  of  the  tibia  and  capsule,  and  thence  to 
the  head  of  the  fibula,  the  origin  of  the  soleus  and 
joint  which  as  they  are  reflected  forwards,  inos- 
culate with  the  inferior  articular  branches. 

N.  B.  These  branches  are  sent  off  before  the 
artery  passes  out  of  the  ham. 

C.  The  tibiae  recurrent — winding  to  the 
anterior  surface  of  the  knee,  between  the  superior 
part  of  the  tibial  and  extensor  muscles,  or  bending 
upwards  through  the  substance  of  these  muscles  ; 
and  giving 

Many  branches  to  these  muscles  and  the  ligaments  con. 
necting  the  bones. 

A branch  winding  round  the  head  of  the  fibula,  as  it 
passes  outwards  under  the  common  extensor  of  the  toes 
and  the  peroneus  longus,  and  inosculating  with  the 
branch  B. 

Branches  running  to  the  vascular  plexus  on  the_  liga. 
ments  of  the  knee,  and  forming  numerous  inosculations 
with  the  inferior  articular. 

D.  A LARGE  BR  anch — running  down  upon 
the  fibula,  between  the  tibialis  and  peroneus  Ion- 


141 


gus,  and  between  the  same  peroneus  and  exten- 
sor communis,  and  inosculating,  near  its  inferior 
extremity,  with  the  fibulcir. 

E.  Many  minute  branches rising, 

through  the  whole  course  of  the  artery,  between 
the  two  bones  of  the  leg,  distributed  to  the  tibia* 
lis  anticus,  extensors,  peronei,  aponeurosis,  and 
periosteum  of  the  bone,  chiefly  of  the  tibia,  vari- 
ously interwoven  with  one  another,  and  below  with 
the  jibular. 

F.  Branches — partly  sent  off  to  the  extensor 
tendons  while  the  trunk  lies  upon  the  naked  tibia, 
partty  spreading,  in  a retrograde  course,  on  the 
surface  of  the  bone,  covered  by  the  aponeurosis, 
and  meeting  here  the  posterior  tibial  and  anterior 
jibular . 

G.  The  INTERNAL  MALLEOLAR Spreading 

variously  while  running  down  on  the  inner  ankle  ; 
inosculating,  by  ascending  branches  with  the  pre- 
ceding ramuli,  and  stretching,  with  descending 
branches,  to  the  capsule,  astragalus,  os  naviculare, 
and  cuneiforme  ; and  uniting,  in  various  places, 
with  branches  of  the  internal  plantar. 

H.  The  e ETERNAL  MALLEOLAR forming  a 

large  communication,  in  the  interosseous  space,  or 
a little  below  it,  with  the  anterior  jibula , or  some 
of  its  branches — winding  to  the  external  ankle, 
where  it  sends,  if  not  sooner,  branches  to  the  pero- 
neus brevis,  the  joint,  the  short  common  exten- 
sor, and  the  tendons  of  the  peronei ; forming  un- 
der these  tendons  many  inosculations  with  the 


142 


posterior  fibula , and  anteriorly  with  the  anterior 
fibula.  It  at  last  reaches  the  tarsal  arc  h.  It  often 
exhausts  the  whole  anterior  fibula , or  rather  this 
takes  the  course  of  the  malleolar. 

I.  Many  branches — passing,  under  the 
transverse  ligament,  to  the  extremity  of  the  tibia, 
the  hollow  of  the  tarsus,  capsule,  extensor  tendons, 
the  most  of  the  tarsal  bones,  particularly  the  astra- 
galus, and  the  short  extensor.  Some  of  these, 
winding  on  the  tarsal  bones,  and  bending  with 
ramuli  to  the  planta,  run,  on  one  side,  near  the  ten- 
dons of  the  peronei,  to  the  fibula ; and,  on  the  other, 
beyond  the  inner  margin  of  the  tarsus  to  the  inter- 
nal plantar. 

K.  The  TRANSVERSE  TARSAL,  Or  TARSAL 

sent  from  the  external  side  of  the  trunk,  outwards 
and  downwards,  under  the  extensor  brevis,  to  the 
surface  of  the  second  row  of  tarsal  bones,  uniting, 
at  the  edge  of  the  fifth  metatarsal  bone,  with  the 
external  plantar;  and  thus  forming  the  tarsal  arch. 
From  this  trunk  generally  proceed, 

A Branch — running  outwards,  between  the  articulation 
of  the  tibia  and  fibula,  with  the  astragalus  and  after  send, 
ing  twigs  to  each  articulation,  inosculating  with  the  poste- 
rior fibular  and  external  malleolar. 

A Branch — sinking  deep  into  the  fovea  or  pit  of  the 
tarsus,  and  there  supplying  its  ligaments  and  fat. 

Branches — rising,  in  various  places,  and  exhausted  on 
the  extensor  brevis. 

Branches — distributed  between  the  cuneiform  bones 
and  cuboides  of  the  tarsus. 


143 


The  First  Dorso.metatarsyl , or  Dorso-inierosseal — ■ 
lying  in  the  space  between  the  second  and  third  metatarsal 
bones  and  the  interosseous  muscle  ; and  after  running  to 
the  root  of  the  tees,  and  giving  branches  to  the  extensor 
tendons,  and  others  to  inosculate  with  the  posterior  and 
anterior  perforants  and  transverse  metatarsals , exhaust- 
ing itself  in  the  bifurcation  of  the  planta-digital  artery. 

The  Second  Dorso-metatarsal , or  Dorso-interosseal — 
running,  like  the  last,  to  the  third  interval,  and  terminat- 
ing in  a similar  manner. 

The  Third  Dorso-metatarsal , or  Dorso-interosseal — 
rising,  near  the  os  cuboides  : running  in  the  fourth  interval 
of  the  metatarsal  bones,  and  supplying  similar  branches  as 
the  former  metatarsals. 

A Branch — rising  at  the  fifth  metatarsal  bone  from  the 
inosculation  of  the  transverse  tarsal  and  external  plan- 
tar ; running  along  this  bone,  and  exhausting  itself  by 
some  ramuli,  upon  the  adductor  of  the  little  toe. 

N.  B.  The  Dorso.metatarsals , or  Dorso-interossealsy 
often  arise  from  the  transverse  metatarsal , in  which  case  the 
transverse  tarsal  only  produces  minute  branches,  inoscu- 
lating near  their  origin,  with  the  dorso.metatarsals.  Some- 
times, also,  the  dorso.metatarsals  give  origin,  by  meeting 
with  the  per  jo  rants,  to  one  or  two  planta-digital  branches ; 
or  produce  other  digitals  spreading  on  the  back  of  the  toes, 
and  inosculating  with  the  true  digitals  of  the  external  plan- 
tar ; or  producing,  as  in  the  hand,  dorsal  branches.  The 
anterior  perforants , penetrating,  near  the  roots  of  the  toes, 
the  metatarsal  interstices,  seem  to  arise  from  these  dorso- 
fnetatarsuls;  or  if  they  have  issued  from  the  planta-mela- 
tarsals  and  digitals , anastomose  with  them  in  the  same 
place. 

L.  Branches — distributed,  from  the  inner 
edge  of  the  tibial  artery,  to  the  internal  side  of  the 
tibia,  the  extensor  tendons,  the  periosteum,  the 


144 


tendon  of  the  tibialis  anticus,  and  the  naviculare 
and  first  cuneiform  bone. 

M.  A branch — running  on  the  surface  of 
the  naviculare  towards  the  plantar  side  of  the  foot, 
where  covered  by  the  adductor  pollicis,  to  which 
it  gives  branches,  it  inosculates  with  one  or  two 
branches  of  the  internal  plantar. 

N.  A branch  to  the  adductor  pollicis,  first 
running  along  the  margin  of  the  first  metatarsal 
bone,  and  then  disappearing  on  the  inner  side  of 
the  dorsum  of  the  great  toe. 

O.  A branch — issuing  from  the  external 
edge,  between  the  transverse  tarsal  and  transverse 
metatarsal  arteries,  giving  twigs  to  the  extensor 
tendons  and  the  short  common  extensor. 

P.  The  TRANSVERSE  METATARSAL  ARTE- 
RY— varying  in  size,  and  sometimes  entirely 
wanting,  according  to  the  number  and  magnitude 
of  the  branches  which  are  sent  off  from  the  trans- 
verse tarsal.  It  runs  to  the  commencement  of 
the  first  and  second  dorso- metatarsal  bones,  and 
passing  transversely  to  the  little  toe,  gives  rise  to 
metatarsal  branches,  if  they  have  not  already  been 
supplied  by  the  transverse  tarsal.  Though 
smaller  and  shorter  than  usual,  it  generally  gives 
origin  to  the  metatarsal  of  the  third  interval,  and 

O 

the  dorsal  branches  of  the  third  toe.  Its  ultimate 
branch,  winding  near  the  os  cuboides,  under  the 
tendon  of  the  small  peroneus,  is  partly  exhausted 


145 


on  the  adductor  of  the  little  toe  and  peroneal  ten- 
dons, and  partly  on  the  plantar  integuments. 

Q.  The  DORSO-METATARSAL,  Or  EXTERNAL 
dorsal  of  the  great  toe — the  superficial 
branch  of  the  anterior  tibial  artery  as  it  is  now 
about  to  terminate.  It  traverses  on  the  interos- 
seous muscle,  the  outer  margin  of  the  first  me- 
tatarsal bone. 

R.  The  deep  anastomotic  branch — 
sinking  into  the  plantar  side  of  the  foot,  where  it 
again  appears;  and  after  sending  branches  to  the 
abductor  and  adductor,  inosculating  with  the 
plantar  arch.  From  this  inosculation,  or  some- 
times sooner,  arises  the  planta-pollicar , a remarka- 
ble artery  of  the  plantar  side  of  the  great  toe,  of 
which  I shall  give  a description  along  with  the 
plantar  branches. 


THE  POSTERIOR.  TIBIAL  ARTERT. 

The  other  branch  of  the  Popliteal  Artery, 
where  it  divides  at  the  superior  extremity  of 
the  soleus — passing  down,  under  the  soleus, 
upon  the  posterior  surface  of  the  flexor  lon- 
gus  and  tibialis  posticus,  to  the  lower  extre- 
mity of  the  tibia,  is  afterwards  inflected 
inwards  to  the  plantar  side  of  the  foot,  run- 
18 


146 


ning  between  the  tendo  Achilles  and  the 
epiphysis  of  the  tibial  behind  the  internal 
ankle.  While  there,  covered  by  the  lacini- 
ated  ligament,  and  involved  in  fat,  it  meets, 
on  the  inner  side  of  the  foot,  the  broad  ex- 
tremity of  the  abductor  pollicis,  and  divides 
into  two  branches  : one  of  which  passing  to 
the  great  toe,  I call  the  Internal  Plantar  ; the 
other,  denominated  External  Plantar , runs 
to  the  sole,  between  the  flexor  brevis  and 
longus,  and  under  these,  still  deeper,  to  the 
fifth  metatarsal  bone.  Here  returning  to  the 
great  toe,  by  an  oblique  and  transverse  flex- 
ion, under  the  tendons  of  the  flexor  longus,  it 
forms  the  plantar  arch.  The  branches  issu- 
ing from  this  artery  I shall  enumerate  in  the 
order  in  which  they  are  exhibited. 

Branches  to  the  inner  head  of  the  gastrocnemius ; 
often  wanting. 

A.  The  LARGE  NUTRITIOUS  ARTERY  of  the 
tibia,  or  posterior  interosseal — spread- 
ing extensively  downwards,  between  the  flexor 
of  the  toes  and  posterior  tibial , above  the  interos- 
seous ligament,  and  inosculating  with  the  fibular 


147 


at  the  inferior  extremity  of  the  tibia.  From  this 
issues 

A Branch  to  the  soleus,  popliteus,  and  periosteum  of 
the  tibia,  communicating  with  the  descending  branch  of 
the  inferior  interno-articular. 

A Branch  to  the  tibialis  posticus. 

A Nutritious  Branch — entering  the  bone,  and  distribut. 
ing  its  twigs,  upwards  and  downwards. 

Branches — winding  through  the  whole  course  of  the 
artery,  partly  "on  the  periosteum  of  the  tibia,  and  partly 
on  the  tibial  muscle,  and  the  common  flexor. 

B.  A large  branch — winding  round  the 
external  head  of  the  fibula,  under  the  muscles, 
after  giving  a twig  to  the  soleus,  and  receiving 
some  anastomotic  branches  of  the  tibial  recur- 
rent. 

C.  Many  large  branches  to  the  soleus, 
interwoven  every  where  with  fibular  twigs. 

D.  Some  cutaneous  branches — running 
out  far  with  the  veins  and  nerves,  and  anastomos- 
ing, upwards  and  downwards,  with  the  anterior 
tibial. 

E.  The  common  fibular,  or  peroneal — 
very  irregular  in  size  and  the  distribution  of  its 
branches.  It  often  equals  in  dimension  the  ante- 
rior tibial;  it  is  sometimes  entirely  wanting;  and 
at  other  times  is  rather  smaller  than  the  posterior 
tibial.  After  rising  near  the  superior  extremity  of 
the  tibialis  posticus , it  descends  between  this 
muscle  and  the  flexor  pollicis.  A little  lower  it 


148 


js  covered  by  the  flexor  pollicis ; and,  at  last 
escapes  the  eye  of  the  dissector,  between  the  two 
bones,  where  it  touches  the  interosseous  ligament. 
Near  the  inferior  extremity  of  the  bones,  where 
they  are  more  closely  connected,  it  divides  into  the 
anterior  and  posterior  jibular  arteries.  It  gives 

Branches— passing  through  the  soleus  to  the  skin,  inos- 
culating with  other  inferior  fibnlar  twigs,  and  with 
branches  of  the  posterior  tibial. 

A Branch — penetrating  the  peroneus  longus  and  the 
skin. 

Branches — partly  exhausted  on  the  tibialis  and  the 
common  flexor  of  the  great  toe,  and  partly  spreading  on 
the  periosteum  of  the  fibula. 

Many  branches — .winding  tortuously,  in  various  places, 
under  the  flexor  pollicis,  and  peroneus  longus  to  the 
anterior  part  of  the  fibula,  inosculating  there,  upwards 
and  downwards,  with,  twigs  from  the  anterior  tibial. 

Many  Branches — rising,  in  various  places,  from  the 
descending  trunk,  and  distributed  to  the  tibialis  posticus, 
peronei,  flexor  pollicis,  the  inferior  tendon  of  the  soleus 
and  gastrocnemius,  the  periosteum,  and  skin.  Of  these, 
some  perforate  the  interosseous  ligament,  and  terminate 
between  the  anterior  muscles. 

The  Nutritious  Artery  of  the  Fibula — the  last  of  the 
branches  which  rise  from  the  trunk  before  it  is  covered 
by  the  flexor  pollicis,  ramifying  on  the  periosteum  and 
the  substance  of  the  bone. 

The  Posterior  Fibnlar — the  largest  and  most  regular 
branch  of  the  common  Jibular.  As  it  proceeds  from  its 
cavity  backwards  and  outwards,  itbegins  to  descend  ; and 
after  running  behind  the  external  malleolus,  to  the  outer 
and  hollow  surface  of  the  os  calcis,  it  inosculates,  under 
the  abductor  of  the  little  toe,  before  the  tuberosity  of  the 


149 


os  calcis,  with  some  branches  of  the  external  filantar , or 
sometimes  is  wholly  expended  on  this  abductor  muscle 
and  the  skin.  It  often  gives 

Branches  to  the  long  flexors  of  the  toes  and  the  pe- 
ronei. 

A Large  Transverse  Anastomotic  branch-— uniting,  on 
the  periosteum  of  the  tibia,  and  under  the  tendons  of  the 
gastrocnemius,  and  the  other  muscles,  with  the  posterior 
tibial,  and  some  branches  of  the  anterior  tibial.  Other 
ramuli  are  sometimes  sent  from  this  branch  to  the  ankle 
joint  and  tendo  Achilles,  which,  uniting  with  others  from 
the  fibular  and  the  external  malleolar  of  the  anterior 
tibial , reach  the  outer  surface  of  the  os  calcis. 

A Branch — sometimes  single — sometimes  double — form- 
ing a plexus  in  the  external  cavity  of  the  calcaneum,  or 
os  calcis,  and  anastomosing  frequently  with  the  anterior 
tibial  branches. 

A Branch — as  the  artery  runs  to  the  external  side  of  the 
calcaneum,  forming,  under  the  ligament  that  unites  the 
tibia  and  fibula,  a new  communication  with  the  posterior 
tibial , and,  by  twigs,  sent  outwards,  with  the  external 
malleolar. 

Branches  to  the  peroneal  tendons  and  sheaths,  forming 
a plexus  with  the  anterior  fibular  when  present. 

The  Anterior  Fibular — often  wanting — when  present, 
passes  through  the  interstice  of  the  crural  bones,  running, 
downwards  and  forwards,  in  the  angle  between  the  extre- 
mities of  the  tibia  and  fibula,  behind  the  extensor  pollicis 
and  the  short  peroneus,  where  it  inosculates  with  the  ex- 
ternal malleolar ; and  then  proceeding,  under  the  tendon 
of  the  peroneus,  to  the  os  cuboides,  where  it  lies  concealed 
between  this  bone  and  the  abductor  muscle,  inosculates 
partly  with  the  external  plantar,  and  partly  terminates  on 
the  skin. 


150 


F.  Numerous  branches — distributed,  in  the 
course  of  the  artery,  to  the  adjoining  flexor  mus- 
cles, tibialis  posticus,  soleus,  tendo  Achilles,  nerve 
and  skin. 

G.  Transverse  branches — often  double — 
anastomosing,  already  noticed,  with  the  posterior 
jibular. 

H.  A branch — forming  a plexus,  at  the  epi- 
physis of  the  tibia  and  its  malleolus  upon  the 
periosteum,  with  some  superior  branches  of  the 
posterior  tibial  and  internal  malleolar , and  sending 
sometimes  twigs  to  the  capsule  of  the  joint. 

I.  Branches  to  the  flexor  tendons  and  their 
sheaths. 

K.  Two  large  branches — issuing  from  the 
trunk  as  it  runs  along  the  lateral  concavity  of  the 
heel,  at  the  tuberosity  of  the  calcaneum,  spreading- 
out  upon  its  periosteum  and  aponeurosis,  as  also 
upon  the  abductor  pollicis  and  skin  ; and  inoscu- 
lating with  branches  of  the  Jibular. 

L.  A deep  branch — passing,  under  the  ten- 
dons, to  the  capsule  of  the  astragalus  and  calca- 
neum, and  the  bones. 

M.  Another  deep  branch — running  out  to 
the  other  adjoining  bones  and  their  ligaments,  and 
to  the  articulation  of  the  tibia  and  astragalus. 

N.  The  external  plantar — the  larger 
branch  of  the  posterior  tibial — passing  gradually 
outwards  and  forwards,  between  the  short  flexor 
of  the  toes,  and  the  massa  carnea ; or,  under  this 
muscle,  to  the  inner  edge  of  the  abductor  of  the 


151 


little  toe.  As  it  proceeds  to  the  base  of  the  meta- 
tarsal bone  of  the  little  toe,  between  the  flexor  bre- 
vis and  abductor,  it  runs  gradually  inwards  to  the 
great  toe,  with  alternate  flexions;  and,  passing 
over  the  interosseous  muscles,  forms  the  plantar 
arch ; which,  at  last,  is  wholly  received  by  the 
anterior  tibial , in  the  first  interstice  of  the  meta- 
tarsal bones,  under  the  abductor  pollicis.  Its 
branches  are, 

A Transverse  Anastomotic  Branch — running  outwards 
upon  the  naked  bone,  along  the  anterior  tuberosity  of  the 
os  calcis,  and  forming  a large  inosculation  with  branches 
of  the  anterior  tibial , at  the  inner  side  of  the  tuberosity, 
and  with  the  posterior  fibular  at  the  outer  side;  consti- 
tuting, at  the  same  time,  a vascular  plexus,  from  which 
many  branches  are  sent  to  the  bone,  flexor  brevis,  aponeu- 
rosis, and  skin. 

Branches  to  the  large  ligameut  of  the  calcaneum. 

Many  Branches — while  the  truuk  runs  above  or  below 
the  massa  carnea,  and  passes  exposed  between  the  flexor 
and  abductor  minimus,  sent  to  this  muscle  and  the  flexor 
brevis,  and  through  this,  or  near  its  external  margin, 
liberally  distributed  to  the  aponeurosis  and  skin. 

The  First  Deep  Branch,  or  First  Profunda — running 
to  the  abductor  and  flexor  of  the  little  toe,  and  uniting 
with  the  posterior  fibula  on  the  external  and  lateral  part 
of  the  calcaneum,  and  with  the  deep  branch  of  the  internal 
plantar  upon  the  surface  of  the  calcaneum  on  the  internal 
side  of  the  same  bone. 

The  Secojid  Deep  Branch,  or  Second  Profunda — rising 
at  the  termination  of  the  os  cuboides  ; and,  while  it  ob- 
serves the  same  course  outwards  as  the  last,  forming  simi- 
lar and  new  inosculations  with  the  anterior  fibular  and 
transverse  tarsal.  It  also  contributes  to  the  plexus  that 


152 


is  spread  out  iu  the  cavity  of  the  foot,  and  among  the  liga- 
ments of  the  tarsal  bones. 

Branches  sent  to  the  abductor  of  the  little  toe,  and  the 
periosteum  of  the  adjoining  bones ; spreading  variously 
among  the  bones, and  inosculating  with  the  neighbouring 
ramuli. 

The  Plantar  digital , or  External  Plantar  of  the  Little 
Toe — issuing  from  the  trunk  as  it  touches  the  base  of  the 
fifth  metatarsal  bone,  and  begins  the  formation  of  the  arcli. 
While  it  accompanies  this  bone  forwards  covered  by  the 
flexor  and  adductor  of  the  little  toe,  it  distributes  branches 
to  these  muscles  and  skin.  At  the  other  extremity  of  this 
fifth  metatarsal  bone,  it  receives  a transverse  twig  from 
the  external  plantar,  or  the  adjoining  digital ; then  passes 
over  the  inferior  or  plantar  surface  of  the  bone,  and,  on 
the  outer  or  fibular  side,  reaches  the  apex  of  the  little  toe. 

The  Second  Plantar  digital — rising  in  the  fourth  inter- 
stice of  the  metatarsal  bones,  above  the  interossei,  at  the 
basis  of  the  toes,  and  while  there,  covered  by  the  trans- 
verse muscle,  dividing  into  the  digito.tibial , or  internal 
plantar  of  the  little  toe,  and  the  digito-fibular , or  exter. 
nal plantar  of  the  fourth  toe.  Sending  out 

Numerous  Branches  to  the  skin. 

Branches  to  the  abductor  of  the  little  toe. 

Branches  anastomosing  with  the  planta-mctatarsal , and 
others  uniting  with  the  metatarsals. 

The  Third  Planta-digital — running  between  the  third 
and  fourth  metatarsal  bones,  and  giving  origin  to  the 
digito.tibial  of  the  fourth  toe,  and  the  digito-fibular  of  the 
third.  From  this  arise 

Branches — uniting  with  the  external  branch  of  the  in- 
ternal plantar. 

Small  and  Superficial  Branches  to  the  adjoining  lumbri- 
cals  and  transverse  muscles. 

Anterior  Perforants — dispersed  in  this  third  interstice 
to  the  capsules  of  the  joints. 


153 


The  Fourth  Planta-digital — running  between  the  se, 
cond  and  third  metatarsal  bones,  and  giving  rise  to  the 
digit o tibial  of  the  third  toe,  and  the  digito-Jibular  of  the 
second.  From  this  branches  issue,  similar  to  those  at  i. 

Between  these  digitals,  two  or  three  deep  interosseals , 
or  planta-metcdarsal  and  four  perforants,  issue  from  the 
plantar  arch  whose  direction,  though  very  irregular,  de- 
serves to  be  noticed. 

A Planta-melatarsal,  or  Deep  Interosseal  Branch- 
rising  near  the  planta-digital  of  the  little  toe,  and  running 
between  the  sixth  and  seventh  interosseous  muscles.  Af- 
ter sending  off  many  ramuli  to  the  adjoining  muscles,  it 
inosculates  with  the  dorsal  or  anterior  perforant * of  the 
dorso-metatarsal  of  the  fourth  interstice,  and  unites,  near 
the  metatarsal  articulations  of  the  fourth  and  fifth  toe, 
with  the  dorsal  and  plantar  branches  of  the  digitals.  If 
sometimes  gives  a dorso-metatarsal  to  the  fourth  and  fifth 
toes. 

Another  Deep  Planta-metatarsal — the  second  arising 
from  the  arch,  and  running  out,  in  the  third  interstice, 
between  the  fifth  and  sixth  interosseous  muscles.  In  other 
respects,  its  distribution  is  similar  to  the  last,  and  to  that 
of  the  third  deep  planta-metatarsal , when  present. 

The  Plantar , or  Posterior  Perforant  of  the  Fourth 
Interstice — emerging  to  the  dorsum  of  the  foot,  and  unit- 
ing with  the  metatarsal,  after  having  distributed  twigs  to 
the  interosseous  muscles  and  the  ligaments  of  the  metatar. 
sal  articulation. 

The  Plantar,  or  Posterior  Perforant  of  the  Third  In- 
terstices-i-passing  to  the  transverse  metatarsal , after  per- 
forating the  interstice  of  the  bones. 

The  Plantar , or  Posterior  Perforant  of  the  Second 
Interstice — similar  to  the  former,  and  sending  off  twigs  to 
the  adductor  pollicis. 

* Professor  Murray  calls  those  perforants  which  run  from  the 
dorsum  to  the  plantar,  anterior  perforants ; and  those  w’hich  run 
from  the  plantar  to  the  dorsum, posterioperforants, — Translator. 

19 


/ 


154 

The  Plantar , or  Posterior  Perforant  of  the  First  In. 
terstice — terminating  in  the  transverse  metatarsal. 

N.  B.  These  Plantar  Per  for  ants,  besides,  give  a 
branch,  which  runs  with  the  metatarsal  of  its  own  inter- 
stice, as  far  as  the  toe.  The  planta.metatarsals , after 
reaching  the  metatarsal  bones,  inosculate  with  branches  of 
the  transverse  tarsal  or  metatarsal,  and  dorso-digitals. 

Three  branches,  running  in  a retrograde  course,  from 
the  concave  margin  of  the  arch,  and  forming,  in  the  cavity 
of  the  tarsus,  a plexus  with  the  deep  branches  of  the  inter- 
nal and  external  plantars;  distributing  ramuli  to  the  liga- 
ments, adjacent  muscles,  the  sheath  of  theperoneous  lon- 
gus  and  tibialis  posticus,  the  aponeurosis,  and  skin. 

The  External  Plantar,  bending  to  the  first  metatarsal 
interstice,  becomes  larger  by  its  inosculation  with  the 
anterior  filial  and  running  forwards,  under  the  adductor, 
to  the  fibular  side  of  the  metatarsal  bone  of  the  great  toe, 
where  it  sends  a branch  to  the  flexor  brevis,  gives  rise  to 

The  Planta-P ollicar , or  Internal  Pollicar. — This 
remarkable  artery  appears,  at  times,  rather  to  arise  from 
the  anterior  tibial,  which  then  presents  another  anastomo- 
tic branch,  uniting  with  the  external  plantar.  Between 
the  first  and  second  toes,  there  spring  from  this  common 
trunk 

A Branch  sending  out  the  digito-tibial  of  the  second 
toe,  and  the  digito-fibular  of  the  great  toe ; inosculating 
with  th  e profun  da-fib  ul  ar  of  the  internal  plantar. 

The  Digito-tibial  of  the  Great  Toe — passing  over  the 
inferior  or  plautar  surface  of  the  metatarsal  bone  of  the 
great  toe,  under  the  flexors  and  adductors,  and  spreading 
on  the  inner  or  tibial  side  of  this  toe,  as  far  as  its  apex. 
It  receives  the  profunda-median  and  profunda-tibial  of  the 
internal  plantar. 

The  Dorso-tibial  of  the  Great  Toe — bending  outwards, 
and  generally  running  to  the  termination  of  the  second 


15S 


phalanx  and  nail,  and  forming  an  arch  with  the  dorso - 
fibular , which  rises  from  the  anterior  tibial. 

N.  B.  All  the  Digitals  send  many  twigs  to  the  skin, 
bones,  and  ligaments;  and  unless  separate  dorsal  branches 
are  formecf  by  the  union  of  the  metatarsals  and  per jor  ants, 
these  give  origin  to  dorsal  branches , reflected  upwards, 
and  which  form  small  arches  around  the  root  of  the  nails; 
while  the  trunks  themselves,  mutually  inosculating,  form 
on  the  plantar  side  of  the  apex  of  the  toes  arches  similar 
to  those  upon  the  volar  side  of  the  fingers. 

O.  The  internal  plantar — the  smaller 
branch  of  the  divided  trunk — after  rising,-  on  the 
tibial  side,  in  the  sinuosity  of  the  calcaneum, 
between  the  tendon  of  the  tibialis  posticus  and 
the  origin  of  the  abductor  pollicis,  it  [runs  along, 
covered  by  this  muscle,  and  divides,  under  it,  into 
four  branches,  which  follow  the  course  of  the  ab- 
ductor and  flexor  brevis  of  the  great  toe,  to  the 
inferior  extremity  of  the  metatarsal  bone  of  this 
toe,  and  terminate  in  branches  of  the  planta-polli- 
car  that  issues  from  the  anterior  tibial  and  external 
plantar.  It  sends  off, 

A Branch — bending,  under  the  abductor,  to  the  tendons 
of  the  tibialis  posticus  and  flexors,  and  the  periosteum  of 
the  astragalus,  variously  interwoven  with  the  internal 
malleolar , and  with  the  branches  of  the  anterior  tibial. 

Branches  to  the  adductor  and  flexor  brevis  communis. 

A Branch  running  deeply  outwards,  between  the  large 
ligament  of  the  calcaneum  and  themassa  carnea,  distribut- 
ing ramuli  to  the  flexor  brevis,  the  massa  carnea,  and  liga- 
ment, and  inosculating  with  branches  of  the  deep  external 
plantar , running  to  the  tuberosity  of  the  os  calcis. 


156 


The  Profunda-tibial , or  Internal  Deep  Branch  of  the 
Internal  plantar — the  first  ramulus  of  the  four  branches 
that  exhaust  the  internal  plantar — rising  at  the  os  navicu- 
lare,  and  following  the  inner  border  of  the  abductor  pol- 
licis,  or  inner  margin  of  the  planta ; and  disappearing,  at 
last,  in  the  cligito.tibial  of  the  planta-pollicar . 

The  Profunda-median , or  Deep  Middle  Branch  of  the 
Internal  Plantar — the  second  twig  of  the  internal  plantar 
after  its  division. — It  lies  under  the  abductor,  and  after 
running  along  the  middle  cuneiform  bone,  and  the  first 
metatarsal  bone,  unites  with  the  planta-pollicar,  or  digito- 
tibial  branch  of  the  pollicar.  It  sends  also  twigs  to  the 
fat  and  skin,  and  others  inosculating  with  the  former. 

The  Profunda-Fibular , or  Deep  External  Branch  of 
the  Internal  Plantar — the  third  Branch  of  the  trunk — 
rising  at  the  beginning  of  the  cuneiform  bone.  After  run- 
ning forwards,  between  the  flexor  brevis  and  abductor 
pollicis,  towards  the  second  toe,  it  at  last  unites  with  the 
digito.tibial  of  the  second  toe,  and  the  digito-fibular  of 
the  great  toe. 

The  External  Branch  of  the  Internal  Plantar — the 
fourth  division  of  the  trunk — issuing,  a little  sooner,  near 
the  abductor;  winding,  variously  outwards,  between  the 
massa  carnea  and  ligament  of  the  calcaneum  to  the  os  cu- 
boides,  and  sending  twigs  to  the  neighbouring  muscles,  the 
tarsal  ligaments,  and  the  whole  plantar  cavity.  It  anas- 
tomoses with  the  profundee,  with  recurrent  branches  from 
the  arch  o-f  the  external  plantar,  and  with  a branch  of  the 
internal  plantar.  A branch  of  this  artery  sometimes  enters 
the  first  metatarsal  interstice,  and  inosculates  with  the 
transverse  tarsal.  But  it  should  be  remembered  that  the 
branches  of  the  plantar  present  as  numerous  varieties  a? 
the  other  arteries  of  the  foot. 


PliATE  I. 


a.  Division  of  the  Carotid  Artery. 

b.  Larynx. 

c.  Right  Subclavian  Artery. 

d.  Left  Carotid. 

e.  Trachea. 

f.  Left  Subclavian  Artery. 

g.  Arteria  Innominata. 

h.  Aorta. 

i.  Heart. 

k.  Spine. 

l.  Coeliac  Artery. 

212.  Intercostals. 

22.  Descending  Aorta. 

0.  Renal  Arteries. 
j>.  Spermatic. 

q.  Kidneys. 

r.  Lumbal  Artery. 

s.  Right  Iliac. 

t.  Division  of  Iliac. 

22.  Rectum. 

v.  Left  Iliac  Circumflex  Artery. 

w.  Vesical. 

x.  Bladder. 

y.  External  Pudic  Arteries. 

#.  External  Circumflex. 

1.  Arteria  Profunda. 

2.  Penis. 


PtATE  II. 


а.  Inferior  Maxilla. 

б.  Qecipito-Frontal  Muscle. 

c.  Temporal. 

d.  Orbicularis  Palpebrarum. 

e.  Levator  Labii  Superioris  AUeque  Xasi. 

f.  Levator  Anguli  Oris. 

g.  Zygomaticus  Major. 

h.  Depressor  Anguli  Oris. 

i.  Depressor  Labii  Inferioris. 
it.  Orbicularis  Oris. 

l.  Masseter. 

m.  Sterno-Mastoideus. 

n.  Parotid  Gland. 

o.  Submaxillary  Gland. 

p.  Common  Carotid  Artery. 

q.  Superior  Thyroideal. 

v.  Sublingual 

f.  Facial. 

u.  Inferior  Labial. 

v.  Superior  Labial. 

w.  Transversus  Faciei. 

x.  Anastomosis  of  Facial  and  Temporal. 

y.  Occipital. 

а.  Posterior  Auricular  or  Aural. 

1.  Anterior  Auricular. 

2.  Temporal. 

3.  Temporo-Frontal. 
i.  Temporo-Occipital. 

5.  Internal  Carotid. 

б.  Jugular  Vein. 

7.  Facial  Vein. 


PXATE  II. 


P.LATE  III 


PliATE  HI. 


a.  Os  Frontis  divided. 

b.  Os  Temporis  divided. 

c.  Os  Maxillare  Superius. 

d.  Os  Maxillare  Inferius  divided. 

e.  Sterno-Mastoideus  Muscle. 

f.  Sterno-Hyoideus. 
go  Trachea. 

h.  Aorta. 

i.  Right  Subclavian  Artery, 
fe.  Left  Carotid. 

Z.  Right  Carotid. 
in.  Division  of  Carotid. 

n.  Superior  Thyroid. 

o.  Submental. 

p.  Internal  Maxillary. 

q.  Suborhitary. 

r.  Temporal. 

s.  Occipital. 

t.  Posterior  Aural. 

u.  Anterior  Aural. 

v.  Posterior  Temporal. 
tv.  Facial  Nerve. 

cv.  Its  Anastomosis  with  the  Par  Vaguin. 
y.  Sublingual  Nerve. 

%.  Its  Branch  called  Descendens  Noni. 

1.  Par  Vaguin. 

2.  Accessory  Nerve. 

3.  Great  Sympathetic. 

4*.  Its  Superior  Ganglion. 

5.  Branches  of  the  Fifth  Pair. 

6.  Muscles  of  the  Eye. 

7.  Optic  Nerve. 


PXATE  IV. 


а.  Anterior  Lobes  of  the  Brain. 

б.  Middle  Lobes. 

c.  Posterior  Lobes. 

d.  Cerebellum. 

e.  Pons  Varolii. 

f.  Medulla  Spinalis. 

g.  Olfactory  Nerves. 

h.  Optic. 

i.  Motores  Oculorum. 

It.  Pathetic. 

l.  Trigemini. 

m.  Motores  Externi. 

n.  Facial. 

o.  Auditory. 

p.  Par  Vaguin. 

q.  Sublingual. 

r.  Internal  Carotid  Artery. 

s.  Two  Vertebral  Arteries. 

t.  Basilary. 

n.  Communicating  Arteries  or  Circle  of  Willis. 

v.  Anterior  Arteries  of  the  Cerebrum. 

w.  Middle. 

X.  Posterior  or  Deep. 

y.  Superior  or  Anterior  Arteries  of  the  Cerebellum, 
a.  Middle  arteries  of  the  Cerebellum. 

1.  Posterior. 

2.  Arteries  of  the  Pons  Varolii. 

3.  Anterior  Spinal. 


PliATE  IY. 


PXATE  Y. 


PiATE  V. 


a.  Subclavian  Artery, 
ft.  Carotid, 
c.  Superior  Scapular. 

j-  Branches  to  the  dorsum  of  the  Scapula. 

f.  Inferior  Scapular. 

g.  Axillary. 

h.  Posterior  Circumflex. 

?.  Anterior  Circumflex. 

k.  Os  Humeri. 

l.  Part  of  the  Pectoralis  Major  Muscle. 

m.  Brachial  Artery. 

n.  Part  of  the  Deltoid  Muscle. 

o.  Articular  Arteries. 

p.  Biceps  Muscle. 

q.  Ulnar  Artery. 

r.  Tendon  of  the  Biceps. 

s.  Radial  Artery. 

t.  Internal  Interosseal. 

u.  Deep-Seated  Palmar  Arch. 

v.  Superficial  Palmar  Arch  raised. 

w.  Digital  Arteries. 


Plate  VI. 


a.  Inferior  Angle  of  the  Scapula. 
bo  Head  of  the  Os  Humeri. 

c.  Condyles  of  the  Os  Humeri. 

d.  Ulna. 

e.  Radius. 

f.  Serratus  Major  Muscle. 

g.  Biceps. 

h.  Triceps. 

i.  Axillary  Artery. 

fc.  Posterior  Circumflex. 

1.  Anterior  Circumflex. 
in.  Brachial. 

n.  Profunda  Humeri. 

o.  Smaller  Profunda. 

f.  Anastomosis  between  the  Profunda  and  Interosseal. 
q.  External  Interosseal. 
r-  Internal  Interosseal. 

s.  Radial. 

t.  Pollicar. 

it.  Dorsal  Arch. 

v.  Posterior  Interosseal  Perforant. 


PiATB  VI 


Plate  VII. 


PiATE  VII. 


а.  Liver. 

б.  Stomach. 

c.  Omentum. 

d.  Gall  Bladder. 

e.  Right  Kidney. 

f.  Cceliac  Artery. 

g.  Superior  Coronary, 
hi  Aorta. 

i.  Splenic. 

fe.  Right  Coronary. 

l.  Right  Gastro-Epiploic. 

m.  Right  Hepatic. 

n.  Left  Hepatic. 

o.  Cystic. 

p.  Renal. 

r.  Mesenteric. 


Plate  VIII. 


a.  Arch  of  the  Colon. 

b.  Right  Colon. 

c.  Left  Colon. 

d.  Part  of  the  Right  Kidney. 

e.  Left  Kidney. 

f.  Ccecum. 

g.  Part  of  the  Intestine  Ileum. 
li.  Superior  Mesenteric  Artery, 
i.  Right  Colic. 

k.  Middle  Colic. 

l.  Ileo-Colic. 

m.  Inferior  Mesenteric. 

n.  Arch  formed  by  the  Middle  Colic  and  Inferior 

Mesenteric. 


PlATE  VIII, 


Pi ATE  IX, 


»<  09 


Plate  IX. 


а.  Diaphragm. 

б.  Foramen  of  the  Yena  Cava. 

c.  Foramen  of  the  (Esophagus. 

d.  Ureters. 

e.  Kidneys. 

f.  Yena  Cava. 

. Emulgent  Yeins. 

. Capsular  Yeins. 
i.  Aorta, 
fe.  Phrenic  Artery. 

l.  Emulgent. 

m.  Spermatic. 

n.  Inferior  Mesenteric. 

o.  Bifurcation  of  the  Aorta. 

p.  Sacral  Artery. 

q.  Common  Iliac. 

r.  Division  of  Iliac. 

s.  Internal  Iliac. 

t.  External  Iliac. 

u.  Epigastric. 


Pjlate  3f. 


«.  Lumbar  Vertebrse. 

b.  Ossa  Innominata. 

c.  Aorta. 

d.  Bifurcation  of  the  Aorta. 

e.  Sacro-mediau  Artery. 

f.  Common  Iliac. 

g.  External  Iliac. 
lu  Epigastric. 

i.  Circumflex  Iliac, 
fc.  Internal  Iliac. 

I.  Sacro-Lateral. 

Di.  Umbilical. 

II.  Obturator. 

o.  Gluteal. 

p.  Internal  Pudic. 

q.  Ischiadic. 


Plate  X, 


Plate  XI, 


Plate  XI. 


a.  Part  of  the  Os  Pubis. 

b.  Superior  Anterior  Spinous  Process  of  the  Ilium. 

c.  Iliac  and  Psoas  Muscles. 

d.  Pectineus. 

e.  Triceps. 

f.  Gracilis. 

g.  Sartorius. 

h.  Rectus. 

i.  Patella. 

k.  Head  of  the  Tibia. 

l.  Femoral  Artery. 

m.  Profunda. 

n.  External  Circumflex. 

o.  Internal  Circumflex. 

p.  External  Pudic  Arteries. 

q.  Femoral  Artery  perforating  the  Triceps. 

r.  Articular. 


PlATE  XII. 


a.  Gastrocnemii  Muscles, 
ft.  Plantaris. 

c.  Popliteus. 

d.  Tibialis  Posticus. 

e.  Plexor  Longus  Digitorum  Pedis. 

f.  Flexor  Longus  Pollicis. 

g.  Tibia, 
ft.  Fibula. 

i.  Posterior  Tibial  Nerve. 

k.  Astragalus. 

l.  Os  Calcis. 

m.  Popliteal  Artery. 

ii.  Articular. 

o.  Anterior  Tibial. 
jp.  Peroneal. 
q . Posterior  Tibial. 


Plate  XII. 


PiATE  XHI, 


PlATE  XIII. 


a.  Superior  Artery  of  the  Patella. 

b.  Superior  luternal  Articular. 

« 

J Condyles  of  the  Os  Femoris. 

e.  Superior  External  Articular  Artery. 

f.  Inferior  Internal  Articular. 

g.  Inferior  External  Articular. 

h.  Anterior  Tibial  Artery. 

i.  Extensor  Pollieis. 

l 

It.  Extensor  Digitorum  Longus.  ^ Muscles. 

l.  Tibialis  Anticus.  J 

m.  Internal  Articular  Artery  of  the  Ankle. 

n.  External. 

o.  External  Pollicar. 


Plate  XIY. 


a.  Os  Calcis. 
i.  Os  Naviculare. 

c.  Large  Ligament  from  the  Os  Calcis  to  the  Os 

Cuboides. 

d.  Trausverse  Muscle  of  the  foot. 

e.  Metatarsal  Bone  of  the  little  toe. 

f.  Metatarsal  Bone  of  the  great  toe. 

g.  Tendon  of  the  Flexor  Pollieis  Pedis. 

h.  Tendons  of  the  Flexor  Digitorum  Pedis. 

i.  Posterior  Tibial  Artery. 

k.  Internal  Plantar. 

l.  External  Plantar. 

m.  Termination  of  the  Anterior  Tibial. 

n.  Digital  Arteries. 


Plate  XIV, 


PtATE  XV. 


PlATE  XV. 


a.  Biceps  Muscle. 

&.  Basilic  Vein. 

c.  Cephalic  Vein. 

d.  Brachial  Artery. 

e.  Median  Cephalic  Vein. 

f.  External  Cutaneous  Nerve. 

g.  Median  Basilic  Vein. 

li.  Internal  Cutaneous  Nerve. 
i.  Median  Vein. 

fr.  Tendon  of  the  Biceps  Muscle. 


I 

Haller 

ir/3 


